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ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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4/2019
vol. 14
 
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abstract:
Original paper

Impact of thoracic paravertebral block combined with general anesthesia on postoperative cognitive function and serum adiponectin levels in elderly patients undergoing lobectomy

Haihui Xie
1
,
Jianping Zhou
2
,
Wei Du
2
,
Shu Zhang
1
,
Runcheng Huang
1
,
Qi Han
1
,
Qingcong Guo
1

  1. Department of Anesthesiology, Affiliated Dongguan People’s Hospital of Southern Medical University, Dongguan, China
  2. Department of Thoracic Surgery, Affiliated Dongguan People’s Hospital of Southern Medical University, Dongguan, China
Videosurgery Miniinv 2019; 14 (4): 538–544
DOI: https://doi.org/10.5114/wiitm.2019.84742
Online publish date: 2019/11/05
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Introduction
Thoracic paravertebral block (TPVB) can improve postoperative analgesia, inhibiting perioperative stress and the inflammatory response. However, whether it can improve early postoperative cognitive dysfunction (POCD) by altering the secretion and expression of serum ADP remains unclear.

Aim
To investigate the impact of thoracic paravertebral block combined with general anesthesia (TPVB-GA) on postoperative cognitive function and serum adiponectin (ADP) levels in elderly patients undergoing lobectomy.

Material and methods
A total of 120 elderly patients undergoing elective lobectomy were randomly divided into three groups: general anesthesia (GA); TPVB-GA (PG); epidural block combined with general anesthesia (EG). Cognitive function in the three groups was evaluated 1 day before and 7 days after surgery. The serum levels of ADP and S-100 protein were evaluated before anesthesia (T0), 15 min after skin incision (T3), and 7 days after surgery (T5).

Results
Cognitive function scores in the three groups decreased by different extents at T5 (p < 0.05); scores in groups PG and EG were higher than those in group GA (p < 0.05). The serum levels of S-100β protein in the three groups at T3 were higher than those at T0 (p < 0.05); however, serum ADP concentrations were reduced (p < 0.05); the serum levels of S-100β protein in groups PG and EG were lower than those in group GA at T3, while serum ADP levels were higher.

Conclusions
Thoracic paravertebral block or epidural block combined with general anesthesia can improve early postoperative cognitive function in elderly patients undergoing lobectomy. TPVB-GA demonstrated better effects, which may be related to the secretion of ADP.

keywords:

thoracic paravertebral block, lobectomy, postoperative cognitive dysfunction, adiponectin, elderly
  
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