Wang Chenghai, Zheng Baosheng, Lin Changsen, Li Xikai, Li Ruxia, Zhao Luxi, Liu Shijin, Hao Huimei
Department of Anesthesia, Yantaishan Hospital Yantai 264003, Shandong, China.
Department of Anesthesia and Perioperative Medicine, Shandong Provincial Public Health Clinical Center Jinan 250100, Shandong, China.
Am J Cancer Res. 2025 Aug 25;15(8):3728-3739. doi: 10.62347/SQHE7607. eCollection 2025.
To assess the immunomodulatory and analgesic effects of liposomal bupivacaine compared to ropivacaine on erector spinae plane block (ESPB) for patients undergoing thoracoscopic lung cancer surgery.
This retrospective study included 260 patients undergoing thoracoscopic lung cancer surgery. Patients were divided into two groups based on anesthesia methods: the liposomal bupivacaine group (n = 134) and the ropivacaine group (n = 126). Both groups received general anesthesia followed by ESPB. Perioperative inflammatory markers (IL-6, TNF-α, CRP), immunoglobulins (IgA, IgG, IgM), and analgesic outcomes (Numerical Rating Scale (NRS) scores) were measured at various postoperative time points. Cellular inflammatory markers, including white blood cell (WBC) counts and neutrophil percentages, were also assessed. Tumor markers (galectin-3 (Gal-3), carbohydrate antigen 125 (CA125), cytokeratin 21-1 fragment (CY-FRA21-1), soluble programmed death ligand-1 (sPD-L1)) were analyzed at 3-month follow-up.
The liposomal bupivacaine group exhibited significantly reduced inflammatory responses with lower levels of IL-6 (P = 0.005), TNF-α (P = 0.007), and CRP (P = 0.01) at 12-72 hours postoperatively. Immunoglobulin levels were better preserved in this group (IgA P = 0.007, IgG P = 0.016, IgM P = 0.033). Analgesia outcomes were superior, with lower NRS scores at 36 h (P = 0.002) and 72 h (P = 0.006). Cellular inflammatory markers, including WBC counts and neutrophil percentages, were also significantly reduced (P < 0.05). At the 3-month follow-up, the liposomal bupivacaine group showed significantly lower levels of tumor markers, particularly sPD-L1 (all P < 0.001).
Liposomal bupivacaine for ESPB enhances both immunoprotective effects and postoperative analgesia in thoracoscopic lung cancer surgery.
评估与罗哌卡因相比，脂质体布比卡因用于胸腔镜肺癌手术患者竖脊肌平面阻滞（ESPB）时的免疫调节和镇痛效果。
这项回顾性研究纳入了260例行胸腔镜肺癌手术的患者。根据麻醉方法将患者分为两组：脂质体布比卡因组（n = 134）和罗哌卡因组（n = 126）。两组均接受全身麻醉，随后进行ESPB。在术后不同时间点测量围手术期炎症标志物（IL-6、TNF-α、CRP）、免疫球蛋白（IgA、IgG、IgM）和镇痛效果（数字评分量表（NRS）评分）。还评估了细胞炎症标志物，包括白细胞（WBC）计数和中性粒细胞百分比。在3个月随访时分析肿瘤标志物（半乳糖凝集素-3（Gal-3）、糖类抗原125（CA125）、细胞角蛋白21-1片段（CY-FRA21-1）、可溶性程序性死亡配体-1（sPD-L1））。
脂质体布比卡因组在术后12 - 72小时炎症反应显著减轻，IL-6（P = 0.005）、TNF-α（P = 0.007）和CRP（P = 0.01）水平较低。该组免疫球蛋白水平得到更好的维持（IgA P = 0.007，IgG P = 0.016，IgM P = 0.033）。镇痛效果更佳，在36小时（P = 0.002）和72小时（P = 0.006）时NRS评分更低。包括WBC计数和中性粒细胞百分比在内的细胞炎症标志物也显著降低（P < 0.05）。在3个月随访时，脂质体布比卡因组的肿瘤标志物水平显著更低，尤其是sPD-L1（所有P < 0.001）。
脂质体布比卡因用于ESPB可增强胸腔镜肺癌手术中的免疫保护作用和术后镇痛效果。
