Effect of Ultrasound-Guided Stellate Ganglion in Patients Undergoing Thoracoscopic Surgery for Lung Cancer and Risk Factors of Postoperative Acute Pain
WANG Weili, LIU Jiandong HUANG Mingwei, et al
Joint Support Force No. 909 Hospital / Southeast Hospital Affiliated to Xiamen University, Fujian Xiamen 363000, China
Abstract：Objective: To investigate the effect of ultrasound-guided stellate ganglion block (SGB) in patients with thoracoscopy for lung cancer and analyze the risk factors for acute postoperative pain. Methods: A total of 98 patients undergoing thoracoscopic surgery for lung cancer in our hospital from January 2021 to December 2022 were randomly divided into 2 groups, 49 cases in the control group and 49 cases in the study group. In the study group, a right stellate ganglion block was performed at the C6~7 level under ultrasound guidance, and 5mL of 0.5% ropivacaine was given, while in the control group, 5 mL of saline was given at the same location to compare the two groups with perioperative indicators before stellate ganglion block (T1), 5 min (T2) after extubation, and 6:00 am (T3). After one day, pain was assessed by visual analogue scoring method (VAS). According to the VAS score, 29 patients were divided into the acute pain group (VAS 3 points) and 69 patients in the non-acute pain group (VAS <3 points). The risk factors for postoperative acute pain were analyzed.Results: Postoperative extubation time, time to leave the recovery room to SM, sufentanil use, PAPT, postoperative delirium rate, nausea and vomiting rate of the study group were not statistically significant compared with that of the control group (P>0.05), and the postoperative discharge time of the study group was significantly shorter than that of the control group (P<0.05).The levels of epinephrine (E) and norepinephrine (NE) were elevated in both groups at the T2 and T3 time points compared with the T1 time point (P<0.05), but E and NE were significantly lower in the study group than in the control group (P<0.05). After univariate analysis, age, operation time, intercostal space width, and psychological anxiety were the influencing factors of postoperative acute pain in thoracoscopic patients with lung cancer (P<0.05), and after multifactorial binary logistic regression analysis, operation time ≥150min and psychological anxiety were the risk factors of postoperative acute pain in thoracoscopic patients with lung cancer, and intercostal space width ≥1cm was a postoperative protective factor for acute pain (P<0.05).Conclusion: Ultrasound-guided SGB applied to patients undergoing thoracoscopic surgery for lung cancer effectively reduces stress and shortens patients' hospitalization time; postoperative pain is associated with operative time ≥150 min, intercostal space width <1 cm, and psychological anxiety.
王伟立, 刘建东, 黄明伟, 杜小强, 陈建华, 袁媛, 杨建彬, 陈检明. 超声引导下星状神经节在肺癌胸腔镜术患者中的应用效果及术后急性疼痛危险因素分析[J]. 河北医学, 2023, 29(9): 1473-1478.
WANG Weili, LIU Jiandong HUANG Mingwei, et al. Effect of Ultrasound-Guided Stellate Ganglion in Patients Undergoing Thoracoscopic Surgery for Lung Cancer and Risk Factors of Postoperative Acute Pain. HeBei Med, 2023, 29(9): 1473-1478.
[1] 张晓燕,郭占林,王宇飞,等.2012年至2017年内蒙古西部地区某三甲医院肺癌临床特征分析[J].中国病案,2021,22(9):107-110. [2] Glarcher M,Kundt F S,Meissner W,et al.Quality indicators (QI) of acute pain after surgery in european countries[J].Pain Manag Nurs,2021,22(6):730-739. [3] 查晓亮,王进,罗奇,等.超声引导下间断给药星状神经节阻滞术效果和并发症[J].中国介入影像与治疗学,2022,19(9):556-559. [4] Lan K,Zhou J,Sui X,et al.Escalated grades of complications correlate with incremental costs of video-assisted thoracoscopic surgery major lung resection for lung cancer in China[J].Thorac Cancer,2021,12(22):2981-2989. [5] 古翠方,翟明见,吕爱俊,等.超声引导下的星状神经节阻滞可改善老年肺癌患者胸腔镜术后早期睡眠:86例前瞻性随机对照试验[J].南方医科大学学报,2022,42(12):1807-1814. [6] 姚美玲.超声引导下星状神经节阻滞复合全凭静脉麻醉在早期胃癌手术患者中的应用[J].中国医学工程,2022,30(9):60-63. [7] Hamad S H,Montgomery S A,Simon J M,et al.TP53,CDKN2A/P16,and NFE2L2/NRF2 regulate the incidence of pure- and combined-small cell lung cancer in mice (vol 41,pg 3423,2022)[J].Oncogene,2022,41(25):3423-3432. [8] 宋洋,夏冰,吴岳光.肺癌术后长期慢性疼痛的特点及危险因素研究[J].浙江医学,2021,43(16):1757-1760. [9] 崔嬿嬿,贾波,王晓东.Ⅰ期非小细胞肺癌胸腔镜手术治疗后并发症发生的相关影响因素[J].实用癌症杂志,2022,37(11):1842-1844,1854.
2023, Vol. 29 
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