Effects of Thoracic Paravertebral Block on Postoperative Analgesia and Serum Level of Tumor Marker in Lung Cancer Patients Undergoing Video-assisted Thoracoscopic Surgery
10.3779/j.issn.1009-3419.2015.02.10
- VernacularTitle:椎旁阻滞对肺癌根治术患者术后镇痛效果及外周血肿瘤标志物水平的影响
- Author:
CHEN JIHENG
1
;
ZHANG YUNXIAO
;
HUANG CHUAN
;
CHEN KENENG
;
FAN MENGYING
;
FAN ZHIYI
Author Information
1. 100142北京，北京大学肿瘤医院暨北京市肿瘤防治研究所麻醉科，胸外一科
- Keywords:
hToracic paravertebral block;
Lung neoplasms;
Lobectomy;
Tumor marker
- From:
Chinese Journal of Lung Cancer
2015;(2):104-109
- CountryChina
- Language:Chinese
-
Abstract:
Background and objective Perioperative management of pain associated with the prognosis of cancer patients. Optimization of perio-perative analgesia method, then reduce perioperative stress response, reduce opioiddosage, to reduce or even avoid systemic adverse reactions and elevated levels of tumor markers. Serum levels of tumor markers in patients with lung cancer are closely related to tumor growth. Clinical research reports on regional anesthesia effect on tumor markers for lung cancer are still very little in domesticliterature. hTe aim of this study is to evaluate the effects of thoracic paraverte-bral block on postoperative analgesia and serum level of tumor marker in lung cancer patients undergoing video-assisted thoraco-scopic surgery. Methods Lung cancer patients undergoing video-assisted thoracoscopic surgery were randomly divided into 2 groups (n=20 in each group). hTe patients in group G were given only general anesthesia. hTe thoracic paravertebral blockade (PVB) was performed before general anesthesia in patients of group GP. hTe effect of PVB was judged by testing area of block. Patient controlled intravenous analgesia (PCIA) pump started before the end of surgery in 2 groups. Visual analogue scale (VAS) score was recorded atfer extubation 2 h (T1), 24 h (T2) and 48 h (T3) atfer surgery and the times of PCIA and the volume of analgesic drugs used were recorded during 48 h atfer surgery. hTe serum levels of carcino-embryonic antigen (CEA), carbohydrate antigen 199 (CA199), carbohydrate antigen 125 (CA125), neuron-speciifc enolase (NSE), cytokeratin 19 frag-ment (CYFAR21-1) and squamous cell carcinoma (SCC) in 40 lung cancer cases undergoing video-assisted thoracoscopic lo-bectomy were measured before operation and 24 h atfer operation. Results Forty American Society of Anesthesiologists (ASA) physical status I or II patients, aged 20 yr-70 yr, body mass index (BMI) 18 kg/m2-25 kg/m2, scheduled for elective video-assisted thoraeoscopic lobectomy, VAS scores at T1 and T2 were lower in group GP than those in group G (P=0.013, P=0.025, respectively), PCIA times during postoperative analgesia 24 h and 48 h were lower in group GP than those in group G (P=0.021, P=0.026, respectively), analgesic volume used during postoperative analgesia 24 h and 48 h were lower in group GP than those in group G (P=0.006, P=0.011, respectively). hTe level of tumor marker at post-operative were not signiifcantly decreased than preoperative in both groups (P>0.05). Conclusion Patients in group G feel more painful and a higher dosage of dezocine is required to relieve the pain than group GP. hToracic paravertebralblock has no inlfuence on serum level of tumor marker in lung cancer patients undergoing video-assisted thoraeoscopic lobectomy.
