布托啡诺预处理联合超声引导下胸椎旁神经阻滞麻醉 对胸腔镜下肺癌根治术患者镇痛效果及应激反应的影响.

Objective: To explore the influence of butorphanol pretreatment combined with ultrasound-guided thoracic paraverte- bral nerve block anesthesia (TPVB) on analgesic effect and stress response in patients undergoing thoracoscopic radical resection of lung cancer. Methods: Sixty patients with lung cancer in our hospital were selected from May 2021 to June 2022 and were classified into ob- servation group (n=30) and control group (n=30) by random number table method. Both groups received intravenous anesthesia and were treated with patient-controlled intravenous analgesia (PCIA) after surgery, and the observation group performed ultrasound-guided TPVB before surgery and was given butorphanol pretreatment. The hemodynamics, anesthetic effect, postoperative pain status, stress response and occurrence of adverse reactions were compared between the two groups. Results: Compared with To, the heart rate (HR) and mean arterial pressure (MAP) in the two groups were decreased at T1 (P<0.05). The HR and MAP were increased at T2 in the two groups compared with those at T 1(P<0.05). The HR and MAP at T2 and T3 in observation group were lower compared to control group (P<0.05). The propofol dosage, remifentanil dosage, extubation time and PCIA use frequency in observation group were lower, shorter or less than those in control group (P<0.05). At 8 h, 12 h and 24 h after surgery, the pain degrees at rest and cough in observation group were milder than those in control group(P<0.05). After surgery, the levels of epinephrine (E), cortisol (Cor) and adrenocorticotropic hormone (ACTH) were risen in the two groups (P<0.05), but the observation group had lower levels (P<0.05). There was no significant difference in the total incidence rate of adverse reactions between the two groups (P>0.05). Conclusion: Butorphanol pretreatment combined with ultrasound-guided TPVB can control the hemodynamics and total dosage of opioids of patients undergoing thoracoscopic radical resection of lung cancer, shorten the extubation time, and relieve the postoperative pain and stress response. [ABSTRACT FROM AUTHOR]