Effect of thoracic paravertebral block-propofol intravenous balance general anesthesia on serum vascular endothelial growth factor C and transforming growth factor β1 in patients undergoing radical lung cancer resection

Kai WANG; Tongju YANG; Lijun WANG; Zhen WANG; Liyong CHEN

doi:10.16016/j.1000-5404.201808148

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Effect of thoracic paravertebral block-propofol intravenous balance general anesthesia on serum vascular endothelial growth factor C and transforming growth factor β1 in patients undergoing radical lung cancer resection

Clinical Medicine | 更新时间：2026-01-09

- Effect of thoracic paravertebral block-propofol intravenous balance general anesthesia on serum vascular endothelial growth factor C and transforming growth factor β1 in patients undergoing radical lung cancer resection
- Journal of Third Military Medical University Vol. 41, Issue 1, Pages: 85-90(2019)
- 作者机构：
  
  400042 重庆，陆军军医大学(第三军医大学)第三附属医院(野战外科研究所)麻醉科
- 作者简介：
- 基金信息：
- DOI：10.16016/j.1000-5404.201808148
  CLC： R446.112;R614;R734.2
- Received：23 August 2018，
  
  Revised：2018-09-23，
  
  Published：15 January 2019
- 稿件说明：
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Kai WANG, Tongju YANG, Lijun WANG, et al. Effect of thoracic paravertebral block-propofol intravenous balance general anesthesia on serum vascular endothelial growth factor C and transforming growth factor β1 in patients undergoing radical lung cancer resection[J]. Journal of Third Military Medical University, 2019, 41(1): 85-90.
DOI：

Kai WANG, Tongju YANG, Lijun WANG, et al. Effect of thoracic paravertebral block-propofol intravenous balance general anesthesia on serum vascular endothelial growth factor C and transforming growth factor β1 in patients undergoing radical lung cancer resection[J]. Journal of Third Military Medical University, 2019, 41(1): 85-90. DOI： 10.16016/j.1000-5404.201808148.

摘要

目的

比较胸椎旁神经阻滞-丙泊酚静脉复合全麻(paravertebral nerve block-propofol intravenous balance general anesthesia

PPA)和七氟醚吸入复合全麻(sevoflurane inhalation balanced general anesthesia

SGA)对肺癌根治术患者血清VEGF-C、TGF-β1表达的影响。

方法

将肺癌根治术患者分成PPA组(

=23)和SGA组(

=23)。PPA组全麻诱导前行胸椎旁神经阻滞，给予0.5%罗哌卡因(2 mg/kg)，术中靶控输注丙泊酚(血浆浓度2.6~3.2 μg/mL)和瑞芬太尼维持；SGA组术中予以七氟醚(1.0~1.5倍最低有效肺泡浓度)和瑞芬太尼维持。观察两组患者术中和术后24 h阿片类药物用量，术后2、8、24、48、72 h疼痛评分，以及术前和术后24 h血清VEGF-C、TGF-β1浓度。

结果

PPA组术中瑞芬太尼使用量显著少于SGA组(

0.01)，术后24 h舒芬太尼使用量显著少于SGA组(

0.01)，术后2、8、24 h VAS评分显著低于SGA组(

0.01)。术后24 h血清VEGF-C浓度PPA组明显低于SGA组[(629±203)

(908±222) pg/mL

=0.030

]

，血清TGF-β1浓度PPA组也明显低于SGA组[(8.37±2.84)

(10.57±2.47) ng/mL

=0.021

]

。

结论

胸椎旁神经阻滞-丙泊酚静脉复合全麻能降低肺癌根治术患者阿片类药物用量，改善其术后镇痛效果，降低其术后血清中肿瘤血管生成相关因子浓度。

Abstract

Objective

To compare the effects of thoracic paravertebral nerve block-propofol intravenous balance general anesthesia (PPA) and sevoflurane inhalation balanced general anesthesia (SGA) on the serum concentrations of vascular endothelial growth factor C (VEGF-C) and transforming growth factor β1 (TGF-β1) in the patients undergoing radical resection for non-small cell lung cancer performed

via

video-assisted thoracoscopy.

Methods

Lung cancer patients undergoing radical resection were assigned to the PPA(

=23) or SGA(

=23) group. In the PPA group

thoracic paravertebral nerve block anesthetic was performed successfully with local injection of 0.5%ropivacaine(2.0 mg/kg) before induction of anesthesia

anesthesia was maintained with the target controlled infusion (TCI) of propofol (plasma concentration of 2.6~3.2 μg/mL)and intravenous remifentanil. In the SGA group

anesthesia was maintained with 1.0~1.5 (minimum alveolar concentration

MAC) sevoflurane and intravenous remifentanil. We observed opioid consumption intraoperative and 24 h postoperative

the pain scores at 2

72 h after surgery

as well as the serum concentrations of VEGF-C and TGF-β1 before surgery and 24 h after surgery.

Results

The amount of intraoperative remifentanil consumption in the PPA group was significantly lower than in the SGA group (

0.01)

the amount of sufentanil consumption at 24 h postoperatively was significantly lower than in the SGA group (

0.01)

and the VAS score at 2

8 and 24 h postoperatively was significantly lower than in the SGA group (

0.01). At 24 h after surgery

the serum VEGF-C levels were lower in group PPA compared with the group SGA (629±203

908±222 pg/mL

=0.030)

the serum TGF-β1 levels were lower in group PPA compared with the group SGA (8.37±2.84

10.57±2.47 ng/mL

=0.021).

Conclusion

Thoracic paravertebral nerve block-propofol intravenous balance general anesthesia can reduce opioids consumption for patients undergoing radical surgery for lung cancer

improve the postoperative analgesic effect

and reduce the concentration of serum tumor angiogenesis-related factors at 24 h after surgery. It is suggested that thoracic paravertebral nerve block-propofol intravenous balance general anesthesia is better than sevoflurane inhalation balanced general anesthesia for lung cancer patients undergoing radical resection.

关键词

Keywords

references

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