Exploring the analgesic role of esketamine combined with ultrasound-guided nerve block after thoracoscopic radical operation for non-small cell lung cancer
- VernacularTitle:艾司氯胺酮复合超声引导下神经阻滞在非小细胞肺癌胸腔镜下根治术后的镇痛作用探讨
- Author:
Zhibing LI
1
;
Zhe ZHU
1
Author Information
- Publication Type:Journal Article
- Keywords: esketamine; ultrasound-guided nerve block; non-small cell lung cancer(NSCLC); thoracoscopic radical surgery
- From: China Journal of Endoscopy 2025;31(11):20-26
- CountryChina
- Language:Chinese
- Abstract: Objective To explore the analgesic role of esketamine combined with ultrasound-guided nerve block after thoracoscopic radical operation for non-small cell lung cancer(NSCLC).Methods 130 NSCLC patients who were scheduled to undergo thoracoscopic radical resection of lung cancer in this hospital from February 2022 to December 2023 were selected and randomly divided into a conventional group and an observation group,with 65 cases in each group.The conventional group received postoperative conventional analgesia and ultrasound-guided nerve block,while the observation group added esketamine on this basis.The visual analogue scale(VAS)scores,pain mediators[dopamine(DA),substance P(SP),and 5-hydroxytryptamine(5-HT)],stress response indicators[norepinephrine(NE),cortisol(Cor),and prostaglandin E2(PGE2)]and adverse reactions of the two groups of patients were compared.Results There were statistically significant differences in the intergroup and time effects of the VAS scores after surgery between the two groups of patients(P<0.05),but there was no statistically significant difference in the interaction effect(P>0.05).When the time factor was controlled for comparison,the VAS scores of the observation group at 6,12 and 24 h after the operation were significantly lower than those of the control group,and the differences were statistically significant(P<0.05).When controlling for the group factors,the VAS scores of both groups of patients showed a trend of first increasing and then decreasing over time,and the differences at each time point were statistically significant(P<0.05).The comparisons of the intergroup and time effects of DA,5-HT,SP,NE,Cor and PGE2 levels between the two groups of patients showed statistically significant differences(P<0.05),but the comparison of the interaction effect showed no statistically significant difference(P>0.05).When the time factor was controlled for comparison,the levels of DA,5-HT,SP,NE,Cor and PGE2 in the observation group 24 h after the operation were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).When controlling for the group factors,the levels of DA,5-HT,SP,NE,Cor and PGE2 in the two groups showed a trend of first increasing and then decreasing over time,and the differences at each time point were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups of patients(P>0.05).Conclusion The application of esketamine combined with ultrasound-guided nerve block for postoperative analgesia after thoracoscopic radical resection of NSCLC can effectively alleviate postoperative pain and stress response,and does not increase the risk of adverse reactions.It is worth applying in clinical practice.
