关键词: 肝血管瘤, 肝切除术, 椎旁阻滞, 全身麻醉, 疼痛

Abstract: Objective To investigate the efficacy of paravertebral block combined with general anesthesia on pain and postoperative recovery in patients after hepatic hemangioma resection. Methods Eighty patients with hepatic hemangioma were enrolled in our hospital between March 2016 and March 2018,and were randomly divided into observation and control group,with 40 cases in each. All patients received hepatic hemangioma resection,and the patients in control received general anesthesia,and those in the observation received vertebral parasitic nerve block and general anesthesia combination. The visual analogue scale （VAS） was obtained,and serum interleukin-1 （IL-1）,IL-6 and tumor necrosis factor （TNF-α） levels were detected by ELISA. Results At 12 h,24 h and 48 h post-operation,the VAS scores in resting and cough in the observation group were （3.7±1.1,3.0±0.7,2.5±0.5） and （4.5±1.7,4.1±1.0,3.1±0.6）,significantly lower than [（4.5±1.5,3.9±1.1,3.4±0.8） and （5.4±1.8,4.5±1.2,4.3±0.9）,respectively,P<0.05] in the control;serum IL-1,IL-6 and TNF-α levels were （10.5±1.7） pg/ml,（29.6±2.3） pg/ml and（32.3±1.4） pg/ml,all significantly lower than [（14.3±1.9） pg/ml,（38.6±4.4） pg/ml and（44.3±1.8） pg/ml,P<0.05] in the control;the times for eating,walking and hospitalization were（2.0±0.4） d,（2.0±1.4） d and （7.4±2.1） d,much shorter than [（3.6±0.8） d,（4.2±0.4） d and （9.0±1.7） d,P<0.05] in the control. Conclusion The combination of paravertebral nerve block combined with general anesthesia in patients underwent hepatic hemangioma resection effectively reduce postoperative pain and improve postoperative recovery,which might be related to the inhibited cytokine reaction.

Key words: Hepatic hemangioma, Resection, Paravertebral block, General anesthesia, Pain