Effect of sevoflurane combined with intercostal block on postoperative pulmonary function, opioid consumption, and stress response in lung cancer surgery patients.

OBJECTIVE

To investigate the efficacy of sevoflurane combined with intercostal block in lung cancer surgery.

METHODS

A retrospective analysis was conducted on 252 patients who underwent lung cancer surgery between January 2020 and December 2023. Patients were divided into two groups: the sevoflurane with intercostal block group (Group S, n = 108) and the propofol group (Group P, n = 144). Anesthesia protocols involved sevoflurane and intercostal nerve block or propofol. Postoperative pulmonary function, opioid consumption, stress response, and cognitive effects were compared between the two groups.

RESULTS

The VAS scores were significantly lower in Group S at postoperative 2 h (1.96 ± 0.52 vs 2.15 ± 0.56, = 0.005) and 24 h (3.84 ± 0.95 vs 4.14 ± 0.98, = 0.015), indicating superior pain management. Group S also showed better preservation of lung function, with higher FEV1 values at postoperative 2 hours (1.49 ± 0.29 L vs 1.36 ± 0.65 L, = 0.033) and 24 hours (1.59 ± 0.39 L vs 1.45 ± 0.45 L, = 0.012). Opioid consumption was lower in Group S at both postoperative 24 h (1307.52 ± 259.41 µg vs 1742.26 ± 253.12 µg, < 0.001) and 48 h. Cognitive function was better preserved immediately post-surgery in Group S (26.03 ± 4.42 vs 24.14 ± 5.28, = 0.003). However, adverse reactions like nausea were more common in Group S (9.26% vs 2.78%, = 0.026).

CONCLUSION

Sevoflurane combined with intercostal block outperforms propofol in enhancing postoperative pulmonary function, reducing opioid reliance, and modulating stress responses in lung cancer surgery patients.