Application of acetaminophen preemptive analgesia combined with intercostal nerve block in thoracoscopic lobectomy
- VernacularTitle:对乙酰氨基酚超前镇痛复合肋间神经阻滞在胸腔镜肺叶切除术中的应用
- Author:
Le-ye BU
1
;
Qi-gang MA
1
;
Chuan-xin ZHANG
1
;
Guang-yao HE
1
Author Information
- Publication Type:Journal Article
- Keywords: thoracoscopic lobectomy; acetaminophen; preemptive analgesia; intercostal nerve block
- From: Journal of Regional Anatomy and Operative Surgery 2025;34(2):159-163
- CountryChina
- Language:Chinese
- Abstract: Objective To analyze the application effect of acetaminophen preemptive analgesia combined with intercostal nerve block in thoracoscopic lobectomy.Methods A total of 120 patients with lung cancer who underwent thoracoscopic lobectomy admitted to Lu'an Traditional Chinese Medicine Hospital from January 2021 to September 2023 were selected as the study objects,and they were divided into the control group and the observation group according to random number table method,with 60 cases in each group.Patients in the control group were given acetaminophen preemptive analgesia before anesthesia induction,while patients in the observation group were given intercostal nerve block on the basis of the control group.The visual analogue scale(VAS)score,Ramsay sedation score,serum β-endorphin level and prostaglandin E2 level 3,12,24 and 48 hours after operation of patients in the two groups were compared.The stress response indexes such as norepinephrine(NE),epinephrine(E)and serum cortisol(Cor),as well as immune function indexes such as CD3+,CD4+and CD4+/CD8+before anesthesia induction and after extubation of patients in the two groups were compared.The incidence of adverse reactions after extubation of patients in the two groups were compared.Results The VAS scores of patients after surgery in the two groups gradually increased with time,and the Ramsay sedation scores gradually decreased with time.The VAS scores of patients in the observation group were lower than those in the control group at each postoperative time point,and the Ramsay sedation scores were higher than those in the control group,with statistically significant differences(P<0.05).The levels of serum β-endorphin and prostaglandin E2 of patients after surgery in the two groups gradually decreased with time.The levels of serum β-endorphin of patients at each postoperative time point in the observation group were higher than those in the control group,and the levels of prostaglandin E2 of patients at each postoperative time point in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).The levels of NE,E,and Cor after extubation of patients in the two groups were significantly decreased(P<0.05),and those in the observation group were lower than those in the control group(P<0.05).The levels of CD3+,CD4+,and CD4+/CD8+after extubation of patients in the two groups were significantly decreased(P<0.05),and those in the observation group were higher than those in the control group(P<0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group,with statistically significant difference(P<0.05).Conclusion The application of acetaminophen preemptive analgesia combined with intercostal nerve block in thoracoscopic lobectomy has good analgesic and sedative effects on patients,which is helpful to improve patients'immune function and reduce postoperative adverse reactions.
