目的 明确异丙酚对于高血压脑出血患者血清炎性细胞因子的影响。 方法 将2008年3月-2009年3月收治的高血压脑出血患者47例分为两组，异丙酚组采用异丙酚、芬太尼、维库溴铵以及异氟醚诱导和维持麻醉；对照组采用依托咪酯、芬太尼、维库溴铵以及异氟醚诱导和维持麻醉。比较两组患者手术中不同时段血清白细胞介素（IL-6）、肿瘤坏死因子（TNF）、血栓素、内皮素、前列腺素E和降钙素水平。 结果 患者麻醉过程中生命体征平稳，无麻醉相关死亡。术前异丙酚组患者血清IL-6、TNF、血栓素、内皮素、前列腺素E和降钙素水平与对照组比较均无差异(P＞0.05)，而麻醉诱导后差异有统计学意义(P＜0.05)，而且差异随时间延长增大。 结论 采用异丙酚麻醉能降低术中血清炎性细胞因子水平。
ObjectiveTo explore the safety and efficacy of thoracoscopic guided thoracic paravertebral block (TPVB) in resection of lung, and to provide strategies for enhanced recovery after surgery of lung. MethodsA total of 180 patients with thoracoscopic surgery of lung (including sublobar resection and lobectomy) hospitalized between May 2021 and June 2023 were included. Patients were divided into 3 groups. Patients received subcutaneous injection of ropivacaine (concentration: 0.375%, dose: 2 mg/kg) on peripheral incision at chest closing were allocated into a Group A. Patients received ultrasound-guided injection of ropivacaine (concentration: 0.375%, dose: 2 mg/kg) at the TPVB point after chest closing Group B. Patients received thoracoscopic guided injection of ropivacaine (concentration: 0.375%, dose: 2 mg/kg) before chest closing at the TPVB point Group C. The baseline data of each group were compared, and the effectiveness outcomes included perioperative adverse drug reactions, pain scores, postoperative analgesic drug use and postoperative hospital stay were compared among the 3 groups. ResultsThe mean age of patients in the three groups was (62.15±7.36) years, and 108 (60.0%) were females. There were no statistical differences in the baseline data of three groups, including age, weight, gender, incidence of previous underlying diseases, operation time, number of surgical incisions, number of drainage tubes inserted, and dosage of sufentanil or propofol used during surgery (P>0.05). There were no adverse anesthesia events in the 3 groups during the operation, the frequency of self-controlled intravenous analgesia pump in group C was lower than the other two groups (P<0.05), the VAS score in group C was lower than the other two groups (P<0.05), and the incidence of adverse reactions in group C was lower than the other two groups (P<0.05). The rate of postoperative analgesic drug use in group C was lower than the other two groups (P<0.05), and the days of hospital stay in group C and group B were lower than the group A (P<0.05). ConclusionThoracoscopic guided TPVB can reduce postoperative pain without increasing postoperative side effects, which had accelerated the enhanced recovery after surgery of lung.