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Title:
Application of Ultrasound-Guided Erector Spinae Plane Block Combined with General Anesthesia in Thoracoscopic Lobectomy and Its Regulating Effect on Hemodynamics, Oxidative Stress, and Postoperative Pain
Authors:  Dan Xu, B.S., Xun Zhou, M.D., and Lisha Xu, B.S.
  Objective: To explore the application value of ultrasound-guided erector spinae plane block (ESPB) combined with general anesthesia in thoracoscopic lobectomy, as a reference for reducing postoperative pain in patients.
Study Design:
92 patients were randomly divided into control group (n=46) and study group (n=46). Both groups were given general anesthesia, and the study group received combined ultrasound-guided ESPB. Statistics of the intraoperative and postoperative opioid application of the 2 groups (sufentanil, remifentanil, morphine at 12, 24, and 48 hours after surgery), postoperative pain score (VAS), expression of pain factors, oxidative response irritation, and the occurrence of adverse reactions were recorded.
Results:
As compared to the control group, the dosage of sufentanil, remifentanil, and morphine after surgery in the study group was less (p<0.05); VAS scores after operation were lower (p<0.05); levels of heart rate and mean arterial pressure at times before surgery (T0), 10 minutes (T1), 30 minutes (T2), and immediately after surgery (T3) in the study group were higher (p<0.05); the serum neuropeptide, prostaglandin E2, and 5-hydroxytryptamine levels of the study group immediately after the operation and 12 hours after the operation were lower (p<0.05); the serum MDA level of the study group was lower; and the GSH-Px and SOD levels were higher (p<0.05). Comparing the occurrence of adverse reactions between the 2 groups of patients, the combination of ultrasound ESPB and general anesthesia does not increase the vocalization rate of adverse reactions.
Conclusion:
For thoracoscopic lobectomy, ultrasound ESPB combined with general anesthesia can reduce the amount of opioids used. At the same time, it can inhibit the expression of serum pain mediators, stabilize hemodynamics, reduce oxidative stress and postoperative pain, and has high safety.
Keywords:  erector spinae plane block, general anesthesia, hemodynamics, oxidative stress, pain mediators, thoracoscopic lobectomy, thoracic surgery, ultrasound guidance
   
   
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