Protective effect of paravertebral nerve block combined with general anesthesia on postoperative liver injury in patients undergoing laparoscopic hepatectomy—SONG Yuxi, XU Xiao, GAO Xian, DUAN Jiaxiang, WEN Jing, NING Jiaolin　　Department of Anesthesiology, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China

doi:10.16016/j.2097-0927.202410091

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Protective effect of paravertebral nerve block combined with general anesthesia on postoperative liver injury in patients undergoing laparoscopic hepatectomy—SONG Yuxi, XU Xiao, GAO Xian, DUAN Jiaxiang, WEN Jing, NING Jiaolin　　Department of Anesthesiology, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China

Clinical Medicine | 更新时间：2025-04-14

- Protective effect of paravertebral nerve block combined with general anesthesia on postoperative liver injury in patients undergoing laparoscopic hepatectomy—SONG Yuxi, XU Xiao, GAO Xian, DUAN Jiaxiang, WEN Jing, NING Jiaolin　　Department of Anesthesiology, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Journal of Army Medical University Vol. 47, Issue 7, Pages: 720-727(2025)
- 作者机构：
  
  陆军军医大学（第三军医大学）第一附属医院麻醉科，重庆
- 作者简介：
- 基金信息：
  
  the Individualized Training Program for Priority Support Targets of Excellent Talent Pool of Army Medical University
- DOI：10.16016/j.2097-0927.202410091
  CLC： R614.24;R614.41;R657.3
- Received：23 October 2024，
  
  Revised：17 February 2025，
  
  Published：15 April 2025
- 稿件说明：
移动端阅览
宋雨汐,徐小,高宪,等.椎旁神经阻滞复合全身麻醉对腹腔镜下肝切除术后肝损伤的保护作用[J].陆军军医大学学报,2025,47(07):720-727.

，XU X，GAO X，et al.Protective effect of paravertebral nerve block combined with general anesthesia on postoperative liver injury in patients undergoing laparoscopic hepatectomy［J］.J Army Med Univ，2025，47（07）：720-727.DOI：10.16016/j.2097-0927.202410091.
宋雨汐,徐小,高宪,等.椎旁神经阻滞复合全身麻醉对腹腔镜下肝切除术后肝损伤的保护作用[J].陆军军医大学学报,2025,47(07):720-727. DOI：10.16016/j.2097-0927.202410091.

，XU X，GAO X，et al.Protective effect of paravertebral nerve block combined with general anesthesia on postoperative liver injury in patients undergoing laparoscopic hepatectomy［J］.J Army Med Univ，2025，47（07）：720-727.DOI：10.16016/j.2097-0927.202410091. DOI：

摘要

目的

探究椎旁神经阻滞复合全身麻醉对腹腔镜下肝切除（laparoscopic hepatectomy， LH）术后肝损伤的保护作用。

方法

本研究为随机对照研究，纳入2024年4-8月陆军军医大学第一附属医院肝胆外科收治的51例接受LH的患者作为研究对象，采用随机数表法将入组患者随机分为对照组（

=25）和椎旁阻滞组（

=26）。对照组采用全身麻醉，椎旁阻滞组在全麻诱导前进行椎旁神经阻滞，其余医疗处置相同。比较2组患者：术前7 d内、术后第1、2天谷丙转氨酶（alanine aminotransferase，ALT）、谷草转氨酶（aspartate aminotransferase，AST）、胆红素（total bilirubin，TBIL）、白蛋白（albumin，ALB）、全身免疫炎症指数（systemic-immune inflammation index，SII）水平，麻醉诱导前（T1）、建立气腹前5 min（T2）、建立气腹时（T3）、第1次肝门阻断时（T4）心率和平均动脉压（mean arterial pressure，MAP），术中去甲肾上腺素、七氟烷、术后24 h镇痛药物使用量以及2组患者手术时间、拔管时间、麻醉复苏室（postanesthesia care unit， PACU）停留时间、住院时间。

结果

椎旁阻滞组患者术后第1天ALT［178.40（126.55，325.86）

292.20（197.20，468.95）U/L］、术后第2天SII［704.13（486.61，1 078.59）

1 075.09（753.80，1 614.38）］、术后24 h镇痛药使用量［29.70（27.37，32.07）

31.99（28.92，40.81）mg］均较对照组降低（

0.05）；椎旁阻滞组T3、T4时MAP、拔管时间、PACU停留时间及住院时间均较对照组显著下降（

0.05）。

结论

椎旁神经阻滞复合全身麻醉可在一定程度上减轻患者LH术后炎症反应和疼痛，维持血流动力学稳定，进而保护肝损伤。

Abstract

Objective‍　To investigate the protective effect of paravertebral nerve block combined with general anesthesia on liver injury after laparoscopic hepatectomy (LH). Methods‍　‍A randomized controlled trial was conducted on 51 patients undergoing LH in our hospital between April and August 2024. They were randomly divided into control group (

=25

general anesthesia) and paravertebral block group (

=26

paravertebral nerve block before general anesthesia induction). Beside anesthesia

they received same other medical treatment. The foll

owing indicators were compared between the 2 groups

that is

serum levels of alanine aminotransferase (ALT)

aspartate aminotransferase (AST)

total bilirubin (TBIL) and albumin (ALB)

and systemic-immune inflammation (SII) index within 7 d before and on the 1st and 2nd days after surgery; heart rate and mean arterial pressure (MAP) before anesthesia induction (T1)

before pneumoperitoneum establishment (T2)

pneumoperitoneum establishment (T3)

and at the first hilar occlusion (T4); usages of intraoperative norepinephrine

sevoflurane

and analgesic drugs 24 h postoperatively; as well as operation time

extubation time

and lengths of postanesthesia care unit (PACU) stay and hospital stay.Results‍　The paravertebral block group had significantly lower ALT on the 1st day after surgery [178.40 (126.55

325.86)

292.20 (197.20

468.95) U/L

]

SII on the 2nd day after surgery [704.13 (486.61

1 078.59)

1 075.09 (753.80

1 614.38)

]

and amount of analgesic drugs in 24 h after surgery [29.70 (27.37

32.07)

31.99 (28.92

40.81) mg

]

and decreased MAP level at T3 and T4

early extubation

and shorter lengths of PACU stay and hospital stay when compared with the control group (all

0.05). Conclusion‍　Paravertebral nerve block combined with general anesthesia can reduce inflammatory responses

relieve postoperative pain

stabilize hemodynamics for patients undergoing LH

and thereby alleviate postoperative liver injury in them.

关键词

Keywords

references

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Department of General Surgery, Yongchuan Affiliated Hospital, Chongqing Medical University

⁰

DOI：10.16016/j.2097-0927.202410091

摘要

Abstract

关键词

Keywords

references