Effects of ultrasound-guided thoracic paravertebral block combined with general anesthesia on the secretion of pain-related mediators after modified radical mastectomy

• Main Authors: Lei Cheng, Xiao-Lei Tu
• Format: Article
• Language: English
• Published: Editorial Board of Journal of Hainan Medical University 2018-01-01
• Series: Journal of Hainan Medical University
• Subjects: Modified radical mastectomy; U l t r a s o u n d - g u i d e d t h o r a c i c paravertebral block; Pain mediator; Inflammatory factor; Stress hormone
• Online Access: http://www.hnykdxxb.com/PDF/201801/12.pdf

Objective: To investigate the effects of ultrasound-guided thoracic paravertebral block combined with general anesthesia on the secretion of pain-related mediators after modified radical mastectomy. Methods: A total of 108 patients with breast cancer who were treated with modified radical mastectomy in this hospital between July 2015 and February 2017 were divided into the control group (n=54) and paravertebral block group (n=54) by random number table. Control group received routine general anesthesia, and paravertebral block group received ultrasound-guided thoracic paravertebral block combined with general anesthesia. The differences in serum levels of pain mediators, inflammatory factors and stress hormones were compared between the two groups of patients immediately after surgery (T0), 6h after surgery (T1), 12h after surgery (T2) and 24h after surgery (T3). Results: At T0, there was no statistically significant difference in serum levels of pain mediators, inflammatory factors and stress hormones between the two groups. At T1, T2 and T3, serum pain mediators NPY, PGE2 and 5-HT levels of paravertebral block group were lower than those of control group; serum inflammatory factors IL-1, IL-6, TNF-α and MCP-1 levels were lower than those of control group; serum stress hormones ACTH, Cor, AngⅠ and AngⅡ levels were lower than those of control group. Conclusion: ultrasound-guided thoracic paravertebral block combined with general anesthesia can effectively reduce the release of pain mediators and relieve the systemic inflammatory stress response after modified radical mastectomy.