Analysis of Analgesic Effect of Thoracic Paravertebral Nerve Block Combined with General Anesthesia under Ultrasound Guidance in Patients undergoing Thoracoscopic Lung Cancer Radical Resection

AbstractObjective: To study the effects of single-nucleotide polymorphisms of the OPRM1 and ABCB1 genes on the analgesic effect and consumption of sufentanil after thoracoscopic-assisted radical resection of lung cancer.Methods: A total of 225 Chinese Han nationality patients undergoing thoracoscopic-assisted radical resection of lung cancer were enrolled in the present study. Among them, 132 were males (58.67%) and 93 (41.33%) were females having American Society of Anesthesiologists statuses classified as grades I or II. The rs1799971, rs563649 and rs1323040 genotypes of the OPRM1 gene and rs2032582, rs1045642 and rs1128503 genotypes of the ABCB1 gene were detected by Sanger sequencing. The state anxiety index and pressure pain threshold were assessed preoperatively. Sufentanil was administered intravenously to maintain anesthesia. The doses and side effects of sufentanil consumed 6 h (T1), 24 h (T2) and 48 h (T3) after surgery were recorded.Results: The sufentanil doses at T1, T2 and T3 were significantly higher in radical-operation lung cancer patients with mutant homozygous rs1799971 and rs1323040 loci in the OPRM1 gene and rs2032582 and rs1128503 loci in the ABCB1 gene. The doses of sufentanil consumed by mutant heterozygous lung cancer patients at T1, T2 and T3 were significantly higher than those consumed by patients without mutations, and the differences were statistically significant (P<0.05). There was no significant difference in sufentanil doses consumed by lung cancer patients with mutant homozygous, mutant heterozygous and wild-type rs563649 locus of the OPRM1 gene and rs1045642 locus of the ABCB1 gene at T1, T2 and T3 (P>0.05). There was no significant difference in the visual analog scale scores at T1, T2 and T3 for different genotypes of OPRM1 and ABCB1 genes in lung cancer patients (P>0.05). No significant difference was found between the adverse reactions of OPRM1 and ABCB1 genotypes in patients undergoing radical resection of lung cancer (P>0.05).Conclusion: The rs1799971 and rs1323040 polymorphisms of the OPRM1 gene and rs2032582 and rs1128503 polymorphisms of the ABCB1 gene are related to the analgesic effect and consumed dose of sufentanil in Chinese Han patients undergoing radical operation of lung cancer.

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Femoral nerve block with propofol sedation versus general anesthesia in patients with severe cardiac dysfunction undergoing autologous myoblast sheet transplantation

Journal of Anesthesia ◽

10.1007/s00540-017-2376-5 ◽

2017 ◽

Vol 31 (5) ◽

pp. 672-677

Author(s):

Kenta Okitsu ◽

Takeshi Iritakenishi ◽

Akira Iura ◽

Michioki Kuri ◽

Yuji Fujino

Keyword(s):

General Anesthesia ◽

Nerve Block ◽

Cardiac Dysfunction ◽

Femoral Nerve Block ◽

Femoral Nerve ◽

Propofol Sedation

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Lateral popliteal nerve block with ultrasound guidance

Regional Anesthesia and Pain Medicine ◽

10.1097/00115550-200409000-00022 ◽

2004 ◽

Vol 29 (5) ◽

pp. 507-509 ◽

Cited By ~ 14

Author(s):

Andrew T. Gray ◽

Eric L. Huczko ◽

Ingeborg Schafhalter-Zoppoth

Keyword(s):

Nerve Block ◽

Ultrasound Guidance

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Ultrasound Guidance Improves the Success of Sciatic Nerve Block at the Popliteal Fossa

Regional Anesthesia and Pain Medicine ◽

10.1016/j.rapm.2007.10.010 ◽

2008 ◽

Vol 33 (3) ◽

pp. 259-265 ◽

Cited By ~ 7

Author(s):

A PERLAS ◽

R BRULL ◽

V CHAN ◽

C MCCARTNEY ◽

A NUICA ◽

...

Keyword(s):

Sciatic Nerve ◽

Nerve Block ◽

Ultrasound Guidance ◽

Popliteal Fossa ◽

Sciatic Nerve Block

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Obturator Nerve Block: From Anatomy to Ultrasound Guidance

Anesthesia & Analgesia ◽

10.1213/01.ane.0000297273.38071.45 ◽

2008 ◽

Vol 106 (1) ◽

pp. 350-351 ◽

Cited By ~ 2

Author(s):

Yoshihiro Fujiwara ◽

Yutaka Sato ◽

Masato Kitayama ◽

Yasuyuki Shibata ◽

Toru Komatsu ◽

...

Keyword(s):

Nerve Block ◽

Ultrasound Guidance ◽

Obturator Nerve ◽

Obturator Nerve Block

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Randomized controlled trial comparing the efficacy of pectoral nerve block with general anesthesia alone in patients undergoing unilateral mastectomy

Indian Journal of Surgical Oncology ◽

10.1007/s13193-020-01269-2 ◽

2021 ◽

Author(s):

Sudivya Sharma ◽

Shashank Tiwari ◽

Kailash Sharma ◽

Nita Nair

Keyword(s):

Randomized Controlled Trial ◽

General Anesthesia ◽

Nerve Block ◽

Controlled Trial ◽

Randomized Controlled ◽

Pectoral Nerve ◽

Unilateral Mastectomy

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Effect of Different Doses of Propofol and Nerve block Combined with General Anesthesia on The Intraoperative Anesthesia and Postoperative Awakening and Cognitive Function in Elderly Patients with Knee Osteoarthritis

Tobacco Regulatory Science ◽

10.18001/trs.7.4.1.23 ◽

2021 ◽

Vol 7 (4) ◽

pp. 697-705

Author(s):

Jianhui Ma ◽

Meimei Pang ◽

Xin Ding ◽

Shirong Fang ◽

Lichao Chu

Keyword(s):

Cognitive Function ◽

Elderly Patients ◽

General Anesthesia ◽

Nerve Block ◽

Dose Group ◽

Low Dose ◽

High Dose Group ◽

High Dose ◽

Knee Oa ◽

Different Doses

Objective. To explore the effect of different doses of propofol and nerve block combined with general anesthesia on the intraoperative anesthesia and postoperative awakening and cognitive function in elder patients with knee osteoarthritis (OA). Methods. According to the inclusion criteria for research object, we selected 98 elderly patients with knee OA who needed surgery and were admitted to our hospital from January 2019 to January 2021 for the study. Patients were divided into the low dose group (given 2 mg/kg propofol by pumping under constant speed during surgery) and the high dose group (given 4 mg/kg propofol by pumping during surgery) by the number table method to compare their indicators including the intraoperative anesthesia effect, with 49 cases in each group. Results. No between-group difference was shown in the anesthesia time and postoperative VAS scores, but the awakening time of the low dose group was significantly shorter than that of the high dose group (P<0.05); the differences in heart rate (HR) values at various time points between the two groups were not obvious, but the high dose group obtained significantly higher HR values at T4 than the low dose group; the mean arterial pressure (MAP) values of both groups were significantly reduced at Ti and then returned to the level before anesthesia (P>0.05); the bispectral index scores (BIS) of both groups experienced a marked drop at Ti and then recovered gradually, but failed to return to the level at T0 till the end, and a between-group difference in BIS indexes presented at Ti; the plasma corticosterone (CORT) concentration at Ti of both groups were significantly lowered and then returned to the level at T0, with no between-group difference; and compared with the low dose group, the high dose group achieved slightly lower mini-mental state examination (MMSE) scores at 24-72 h after surgery, with no significant difference between them (P>0.05). Conclusion. The therapy of different doses of propofol and nerve block combined with general anesthesia has no significant effect on the cognitive function in elderly knee OA patients after surgery. With the nerve block improving the analgesic effect, a low dose of propofol is good for the postoperative awakening of patients. Different doses of propofol inhibited the stress response to a different degree and produced good anesthesia outcomes in elderly patients, but comparatively speaking, a low-dose propofol ensures more smooth indexes and less effect on the intraoperative hemodynamics.

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