中国体外循环杂志Issue(3)：180-182,3.DOI:10.13498/j.cnki.chin.j.ecc.2014.03.18
双侧胸椎旁神经阻滞对二尖瓣置换术患者体外循环炎症反应的影响
Effect of bilateral thoracic paravertebral block on inflammatory response caused by extracorporeal circulation in patients undergoing mitral valve replacement
摘要
Abstract
Objective To investigate the effect of bilateral thoracic paravertebral block on inflammatory response caused by ex-tracorporeal circulation ( ECC) in patients undergoing mitral valve replacement. Methods Fifty six patients scheduled for mitral valve replacement were randomly divided into two groups ( n=28 in each):bilateral thoracic paravertebral block combined with general anes-thesia group ( group P ) and pure general anesthesia group ( group G ) . Bilateral thoracic paravertebral block and insertion epidural catheter were performed at T3, T4 interspace prior to induction of anesthesia in group P. A test dose of 5 ml of 0.375% ropivacaine was injected through the catheter in two sides;then a bolus dose of 15 ml of 0.375% ropivacaine was injected 5 min later. Blood samples were taken to determine the serum IL-6, IL-8 and TNF-αconcentration before ECC, at the end of operation, postoporative 12 h and 24 h respectively. Clinical data including parameters of heart resuscitation, dosages of positive inotropic agent, time of mechanical ven-tilation and ICU stay, rate of pneumonia, heart failure and death were recorded. Results The levels of the serum IL-6, IL-8 and TNF-αafter operation in both groups were significantly higher than those before ECC ( P<0.05-P<0.01) . There was no significant differ-ence in the level of the serum IL-6 between two groups at postoporative 24 h ( P>0.05);compared with group G, the levels of the serum IL-6, IL-8 and TNF-αwere significantly lower in group P ( P<0.05) at the other points. Dosages of positive inotropic agent, time of mechanical ventilation and rate of heart failure in group P were significantly lower than those in group G ( P<0.05).Conclusion Bilat-eral thoracic paravertebral block can decrease the level of inflammatory factor caused by ECC in patients undergoing mitral valve replace-ment.关键词
神经传导阻滞/胸椎/体外循环/二尖瓣置换术/炎症反应Key words
Nerve block/Thoracic vertebra/Extracorporeal circulation/Mitral valve replacement/Inflammatory response引用本文复制引用
孙立新,潘巍巍,王明山,时飞..双侧胸椎旁神经阻滞对二尖瓣置换术患者体外循环炎症反应的影响[J].中国体外循环杂志,2014,(3):180-182,3.基金项目
青岛市科技发展指导计划项目 （）
