Effect of bilateral paravertebral nerve block on cognitive function in elderly patients undergoing radical gastrectomy for gastric cancer: a prospective randomized double-blind controlled trial. Shang Y, et al, BMC Anesthesiol 2022.
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Résumé et points clés
Objective: To investigate the effect of a bilateral paravertebral block (PVB) on cognitive function in elderly patients undergoing radical gastrectomy for gastric cancer.
Methods: Sixty patients (40 men and 20 women) aged 65-80 undergoing radical gastrectomy surgery under general anaesthesia were included and randomly assigned to either the PVB group or the control group. Patients in the PVB group had before incision a single-shot ultrasound-guided bilateral PVB at the T8 level with 20 mL of ropivacaine 0.375%, while patients in the control group had no block. Patients in both groups had a BIS-guided total intravenous anaesthesia with propofol and remifentanil infusions. Postoperative cognitive function assessed by the mini-mental state examination (MMSE) and NSE (neuron-specific enolase) was the primary outcome.
Results: The awareness time in group PVB was shorter than that in the group C, and the propofol and remifentanil dosages were less than that in group C (P<0.001, P = 0.007, respectively). Furthermore, the change of the MMSE score and the NSE concentration was significant from day0 to day1 and day1 to day2. (P<0.001).
Conclusion: A single-shot bilateral PVB active throughout radical gastrectomy for gastric cancer reduces the needs for general anaesthetic agents and improve postoperative recovery, along with a surrogate evidence for neuroprotective effects.
Trial registration: ChiCTR2200060088 . Registered 18 May 2022.
Références de l'article
- Effect of bilateral paravertebral nerve block on cognitive function in elderly patients undergoing radical gastrectomy for gastric cancer: a prospective randomized double-blind controlled trial.
- Effect of bilateral paravertebral nerve block on cognitive function in elderly patients undergoing radical gastrectomy for gastric cancer: a prospective randomized double-blind controlled trial.
- Shang Y, Qi F, Zheng Z, Yang G, Fei F, Guo Q, Zhu K
- BMC anesthesiology
- 2022
- BMC Anesthesiol. 2022 Jul 15;22(1):224. doi: 10.1186/s12871-022-01764-9.
- Aged, Cognition, Female, Gastrectomy, Humans, Male, *Nerve Block, Pain, Postoperative/diagnosis, *Propofol, Prospective Studies, Remifentanil, *Stomach Neoplasms/surgery
- Syndromes_Geriatriques, Douleur
- Liens
- Traduction automatique en Français sur Google Translate
- DOI: 10.1186/s12871-022-01764-9
- PMID: 35840876
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