Thoracic paravertebral block improves the prognosis of patients undergoing lung cancer surgery.
10.12122/j.issn.1673-4254.2022.10.12
- Author:
Dong Mei MAI
1
;
Yan RAO
1
;
Dong Tai CHEN
1
;
Qiang LI
1
;
Wen HE
1
;
Wei An ZENG
1
;
Wei XING
1
Author Information
1. Department of Anesthesiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.
- Publication Type:Journal Article
- Keywords:
lung cancer surgery;
prognosis;
thoracic paravertebral block
- MeSH:
Humans;
Remifentanil;
Pain, Postoperative;
Nerve Block/methods*;
Analgesics, Opioid;
Prognosis;
Lung Neoplasms/surgery*
- From:
Journal of Southern Medical University
2022;42(10):1526-1531
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To explore the effect of thoracic paravertebral anesthesia (TPVB) on prognosis of patients undergoing resection of lung cancer.
METHODS:This study was conducted among the patients undergoing surgical resection of primary lung cancer under general anesthesia or TPVB combined with general anesthesia (TPVB+GA) between January, 2017 and May, 2018.The patients were enrolled in TPVB+GA group and GA group (control group) using a propensity score matching (PSM) method at the ratio of 1:2 based on their baseline characteristics.The clinical parameters, 5-year overall survival (OS), progression-free survival (PFS) and intraoperative dosage of opioids were compared between the two groups to assess the impact of TPVB on prognosis of the patients.
RESULTS:Forty-seven patients were enrolled in TPVB+GA group and 94 in the control group.Kaplan-Meier survival analysis showed a significantly prolonged PFS in the patients with TPVB+GA (log-rank P=0.034), with an odds ratio (OR) of 0.45(95%CI: 0.33-0.89).Consistently, univariate and multivariate Cox regression analyses identified TPVB as an independent protective prognostic factor for patients with lung cancer resection (P=0.002, OR=0.33, 95%CI: 0.16-0.66).Cox regression analyses indicated that a lower intraoperative dose of remifentanil was significantly correlated with a longer PFS of the patients following lung cancer resection (P=0.017, OR=0.47, 95%CI: 0.25-0.87).Chi-square test confirmed that TPVB, but not general anesthesia, significantly reduced intraoperative dose of remifentanil, indicating a possible synergistic effect of TPVB with opioids to affect the survival of the patients.
CONCLUSION:TPVB can prolong the survival time and improve the prognosis of the patients undergoing surgical resection of lung cancer.
