Effect of erector spinae plane block combined with general anesthesia on early postoperative cognitive function in elderly patients undergoing thoracoscopic radical resection of lung cancer
10.3760/cma.j.cn131073.20200422.00303
- VernacularTitle:竖脊肌平面阻滞联合全麻对老年患者胸腔镜肺癌根治术后早期认知功能的影响
- Author:
Zhenhua HU
1
;
Min WU
;
Peng WANG
;
Shengqun LIU
Author Information
1. 河南省人民医院麻醉与围术期医学科，郑州 450003
- Keywords:
Erector spinae;
Nerve block;
Anesthesia, general;
Thoracoscopy;
Cognition disorders;
Aged
- From:
Chinese Journal of Anesthesiology
2021;41(3):266-269
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of erector spinae plane (ESP) block combined with general anesthesia on early postoperative cognitive function in elderly patients undergoing thoracoscopic radical resection of lung cancer.Methods:Sixty patients of both sexes, aged ≥65 yr, with body mass index< 30 kg/m 2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, scheduled for single-port thoracoscopic radical resection of lung cancer, were divided into 2 groups ( n=30 each) using a random number table method: ESP block plus general anesthesia group (group ESP+ GA) and general anesthesia group (group GA). Ultrasound-guided ESP was performed at T 4 before induction of general anesthesia in group ESP+ GA.The success of the nerve block was determined by pin-prick test at 20 min after nerve block, and then anesthesia was induced.Anesthesia was maintained with propofol plus remifentanil in the two groups.Patient-controlled intravenous analgesia was performed.Venous blood samples were collected at 1 day before operation and 1, 2 and 3 days after operation for determination of plasma S100β protein and neuron-specific enolase (NSE) concentrations by enzyme-linked immunosorbent assay.At 1 day before operation and 3, 5, and 7 days after operation, the early cognitive function was assessed using the Mini-Mental State Examination (MMSE), and the occurrence of postoperative cognitive dysfunction within 7 days after operation was recorded.The intraoperative consumption of propofol, remifentanil and sufentanil was recorded.The occurrence of complications related to ESP block was recorded. Results:Compared with group GA, the consumption of propofol, remifentanil, and sufentanil was significantly reduced, the serum S100β protein concentration and Mini-Mental State Examination score were decreased at 1 and 3 days after operation, serum NSE concentrations were decreased at 1, 3 and 5 days after operation, and the incidence of postoperative cognitive dysfunction was decreased in group ESP+ GA ( P<0.05). ESP block was successful, and no vascular and nerve damage was found in group ESP+ GA. Conclusion:ESP block combined with general anesthesia can improve the early cognitive function after thoracoscopic radical resection of lung cancer in elderly patients.
