Effects of ultrasound-guided erector spinae plane block on the immune function and postoperative recovery of patients undergoing radical mastectomy

Hu, Yunxia; Li, Meiting; Li, Jiacen; Liu, Qiang; Jiang, Rong; Du, Yu

doi:10.21037/gs-21-603

Cited by 5 publications

(5 citation statements)

References 20 publications

(18 reference statements)

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“…The inflammatory response was eliminated, signal transduction was blocked, and the noxious stimulation of peripheral nerve receptors was minimized. Furthermore, various plastic changes were suppressed in neurons, pain level was reduced, and postoperative quality-of-life was improved [29,30]. Our data showed that the probability of vomiting after surgery in the control group was higher than that in the study group; this was because the hemodynamic status of patients in the study group was relatively stable and the intake of opioid doses was reduced.…”

Section: Discussionmentioning

confidence: 68%

Ultrasound-guided thoracic paravertebral nerve block in patients undergoing radical mastectomy

2023

European Journal of Gynaecological Oncology

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This research aims to investigate the effect of ultrasound-guided continuous thoracic paravertebral nerve block in patients undergoing radical mastectomy. Ninety-six patients who underwent radical mastectomy were equally divided into a study group (administered with a continuous thoracic paravertebral nerve block and general anesthesia) and a control group (given conventional general anesthesia) with a random number table. At T2–T4 (T2: immediate tracheal intubation; T3: at skin incision; T4: at extubation), mean artery pressure (MAP) and hear rate (HR) were significantly lower in the study group (p < 0.05); however, there was no significant difference in blood oxygen saturation (SpO2) between the two groups at different time points. At T2–T4, cortisol (Cor) levels were significantly lower in the study group (p < 0.05). At T0–T2, there was no significant difference in the levels of adrenocorticotropic hormone (ACTH) between the two groups. At T3–T4, the levels of ACTH in the study group were significantly lower (p < 0.05). There were no significant differences in blood pressure between the two groups at any time point. At the moment of discharge from the resuscitation room and 2 hours after surgery, the numerical rating scale (NRS) score in the study group was significantly reduced (p < 0.05). The incidence of adverse reactions in the study group was 10.42%; this was lower than that in the control group (33.33%) (p < 0.05). Finally, the use of fentanyl and propofol, and the frequency of analgesic pump use, were significantly lower in the study group (p < 0.05). Ultrasound-guided thoracic paravertebral nerve block can effectively maintain hemodynamic stability, improve the stress response, reduce postoperative pain, reduce the use of anesthetic drugs, and effectively control the incidence of adverse reactions in patients undergoing radical mastectomy.

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Section: Discussionmentioning

confidence: 68%

Ultrasound-guided thoracic paravertebral nerve block in patients undergoing radical mastectomy

2023

European Journal of Gynaecological Oncology

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“…The implementation of an effective analgesia method can reduce the stress response to surgery in the perioperative period and is known to have a certain protective effect on the patient's immune system function. Hu et al [8], in their study comparing the effects of ESPB and Paravertebral Block (PVB) on immune functions and postoperative recovery in breast cancer patients, observed lower VAS scores and higher levels of serum CD4, CD8, and IFNɣ in the ESPB group. CD4+ T lymphocytes have a regulatory role over other lymphocytes.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, oncological surgery, there is a positive effect on survival and metastasis, but has been ordered to regional anesthesia and analgesia techniques that have not yet been consensive [6,7]. It is thought that the sympathetic blockage formed after the erector spinae plane block (ESPB) for postoperative analgesia of breast cancer surgery suppresses the hemodynamic response of surgical stress [8].…”

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confidence: 99%

Comparison of the effect of erector spinae plane block for postoperative analgesia on neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in patients operated for breast cancer

Şahin Karadil,

Gültekin,

Şahin

et al. 2024

The European Research Journal

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Objectives: It was seen that recurrence and metastasis after breast cancer surgery are related to the immune response of the host. Anesthetic agents modulate the surgical stress response or directly impair the functions of immune system cells. In our study, we aimed to compare the effects of nonsteroidal anti-inflammatory drugs and erector spinae plane block, which are among the methods we use for postoperative analgesia, on the neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in patients undergoing breast cancer surgery. Methods: One hundred female patients aged 18-75 years, scheduled for unilateral breast cancer surgery, and who agreed to participate were included in our study. These cases were divided into two groups of the analgesia method: Those with erector spinae plane block (Group E) and those who were administered nonsteroidal anti-inflammatory drugs (Group N). According to the results, preoperative and postoperative neutrophil/lymphocyte ratio and platelet/lymphocyte ratio values were calculated and recorded. Results: Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were statistically higher in both groups in the postoperative period. No statistically significant difference was found when the preoperative and postoperative measurement changes of the laboratory parameters between the groups were compared. Postoperative VAS scores were statistically significantly lower in Group E. Conclusions: We concluded that when erector spinae plane block and nonsteroidal anti-inflammatory drug use were compared in managing postoperative analgesia in breast cancer surgery, their effects on the neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were not superior to each other. However, the erector spinae plane block was superior for adequate pain control.

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“…The application of local anesthetics keeps down the demand for volatile anesthetics and opioids while alleviating the neuroendocrine stress response and perioperative immunosuppression. The results of Hu et al found that ultrasound-guided erect spinal plane (ESP) block had little effect on immune function in patients undergoing radical mastectomy and promoted postoperative recovery (11). In recent years, intravenous lidocaine has attracted great interest from clinicians as part of the perioperative anesthetic regimen because of its analgesic, anti-hyperalgesia, and anti-inflammatory effects and its resultant shortened hospital stay.…”

Section: Introductionmentioning

confidence: 99%

Effect of intravenous lidocaine infusion on perioperative cellular immunity and the quality of postoperative recovery in breast cancer patients: a randomized controlled trial

Wei¹,

Xia²,

Zhang³

et al. 2022

Gland Surg

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Background: Breast cancer has become the most common malignancy worldwide. Experimental and, retrospective, clinical data indicate that anaesthetic technique might influence the risk of metastasis after cancer surgery by modulating the immune system. The purpose of this study is to investigate the effect of perioperative lidocaine injection on immune cells such as T lymphocytes and natural killer cells (NK cells) and the quality of postoperative recovery in breast cancer patients and to propose new ideas and relevant theoretical evidence for the selection of anesthetic protocols for perioperative tumor patients.Methods: Women (n=68) undergoing primary breast tumour resection were randomly assigned to received 2% lidocaine (n=34; group L) or placebo (normal saline; n=34; group S). Venous blood was collected thirty minutes before surgery (T0), after tumor removal (T1), immediately after surgery (T2), 24 h after surgery (T3), and 48 h after surgery (T4). The percentages of NK cells and T lymphocyte subsets (CD3 + , CD4 + , CD8 + , CD4 + /CD8 + ) in peripheral blood were detected by flow cytometry. Patients' quality of recovery-15 (QoR-15) scores were recorded by questionnaire before and 24 h after the operation, as well as intraoperative propofol and remifentanil dosages, the frequency of 24 h postoperative remedial analgesia, and the incidence of nausea and vomiting, dizziness, and chest tightness.Results: There were 62 patients included in the study, and 60 patients were finally analyzed. The difference in the changing trend of NK cell levels in the 2 groups over time was statistically significant (F=7.675, P=0.008). The intraoperative changing trends of CD3 + T cells, CD4 + T cells, and the CD4 + /CD8 + ratio over time differed significantly between the 2 groups of patients (P<0.05), whereas the trends of CD8 + T cells did not differ significantly (P>0.05). The QoR-15 score at 24 h after surgery was higher in Group L (128.50±20.25) than in Group S (117.50±19.50), and the difference was statistically significant (P=0.005).No adverse events such as cardiac arrhythmia and lidocaine toxicity occurred in both groups during the perioperative period.Conclusions: Continuous intravenous pumping of lidocaine during the perioperative period has little effect on immune function in breast cancer patients and promotes postoperative recovery.

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Effects of ultrasound-guided erector spinae plane block on the immune function and postoperative recovery of patients undergoing radical mastectomy

Cited by 5 publications

References 20 publications

Ultrasound-guided thoracic paravertebral nerve block in patients undergoing radical mastectomy

Ultrasound-guided thoracic paravertebral nerve block in patients undergoing radical mastectomy

Comparison of the effect of erector spinae plane block for postoperative analgesia on neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in patients operated for breast cancer

Effect of intravenous lidocaine infusion on perioperative cellular immunity and the quality of postoperative recovery in breast cancer patients: a randomized controlled trial

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