目的 明確異丙酚對于高血壓腦出血患者血清炎性細胞因子的影響。 方法 將2008年3月-2009年3月收治的高血壓腦出血患者47例分為兩組，異丙酚組采用異丙酚、芬太尼、維庫溴銨以及異氟醚誘導和維持麻醉；對照組采用依托咪酯、芬太尼、維庫溴銨以及異氟醚誘導和維持麻醉。比較兩組患者手術中不同時段血清白細胞介素（IL-6）、腫瘤壞死因子（TNF）、血栓素、內皮素、前列腺素E和降鈣素水平。 結果 患者麻醉過程中生命體征平穩，無麻醉相關死亡。術前異丙酚組患者血清IL-6、TNF、血栓素、內皮素、前列腺素E和降鈣素水平與對照組比較均無差異(P＞0.05)，而麻醉誘導后差異有統計學意義(P＜0.05)，而且差異隨時間延長增大。 結論 采用異丙酚麻醉能降低術中血清炎性細胞因子水平。
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 surgery. MethodsA total of 180 patients with thoracoscopic surgery of lung (including sublobar resection and lobectomy) hospitalized between May 2021 and June 2023 were included. There were 108 females and 72 males with an average age of (62.15±7.36) years. 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 into a group B. Patients received thoracoscopic guided injection of ropivacaine (concentration: 0.375%, dose: 2 mg/kg) before chest closing at the TPVB point into a 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. ResultsThere 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, the VAS score, the incidence of adverse reactions, and the rate of postoperative analgesic drug use in group C was less or lower than the other two groups (P<0.05). The hospital stay in the group C and group B were lower than that in 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.