Effect Of Pregabalin Combined With Serratus Anterior Plane Block On The Rehabilitation Quality And Inflammatory Factors Of Patients After Thoracoscopic Radical Resection Of Lung Cancer

Objective: Lung cancer was one of the most common respiratory system malignant tumors with the highest morbidity and mortality.Thoracoscopic surgery had gradually become the primary surgical procedure for lung cancer.Compared with thoracotomy,it had the advantages of smaller incision area and lower pain and irritation.However,it was still a stressful trauma,so how to reduce the stress response and perioperative inflammatory response caused by surgical trauma to accelerate postoperative recovery became a hot spot in current anesthesiology research.Therefore,the purpose of this study was to study the effect of pregabalin combined with serratus anterior plane block on the quality of rehabilitation and inflammatory factors in patients after thoracoscopic radical resection of lung cancer,to evaluate whether this program was effective in reducing surgical stress,thereby promoting postoperative recovery.Methods: From March 2019 to July 2020,60 patients with thoracoscopic radical resection of lung cancer were enrolled.They were divided into control group(n=30)and study group(n=30)by random number table.The control group was given SAPB,and the study group was combined with pregabalin on the basis of the control group.(1)the Visual pain analog scale(VAS)and the Chinese version of the Mc Gi U Pain Questionnaire-2(SF-MPQ-2)were used to evaluate the the degree of acute and neuropathic pain after surgery 12 h,24h,48 h,72h and 96 h.(2)Ramsay scores was used to evaluate sedative effect in preoperative,12 h,24h,48 h,72h and 96 h after operation.(3)ELISA was used to detect the levels of C-reactive protein(CRP)、 interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in preoperative,at 12 h,24h,48 h,72h and 96 h after operation.(4)The quality of life questionnaire of European Cancer Research and Treatment Organization(QLQ-C30)was used to evaluate the quality of life between preoperative and 96 hours after operation.(5)Pulmonary function instrument was used to measure the lung function of the two groups of patients before operation and 96 h after operation: forced vital capacity(FVC),percentage of FVC to predicted value(FVC%),Forced expiratory volume in one second(FEV1),FEV1/FVC,FEV1 as a percentage of predicted value(FEV1%),maximum ventilation per minute(Maximal voluntary ventilation,MVV),peak expiratory flow(PEF),lung carbon monoxide diffusion factor(transfer factor for carbon monoxide of lung,TLCO),and the percentage of TLCO to the predicted value(TLCO%).(6)The State-Trait Anxiety Inventory(STAI)and Pittsburgh Sleep Quality Index(PSQI)were used toevaluate the anxiety and sleep quality of the two groups before and 96 hours after the operation.(7)The adverse reactions of the two groups within 96 hours after operation were recorded,including dizziness,respiratory depression,drowsiness,itching and nausea.Result:1.There was no statistical difference in gender,age,pathological type,and ASA classification between the two groups of patients(P>0.05),which is comparable.2.There was no significant difference between the two groups of preoperative VAS and SF-MPQ-2 scores(P>0.05).The two groups were significantly increased at 12 h and24h after surgery,and the increase was more significantly in the control group(P<0.05),the scores of 48 h,72h,and 96 h showed a downward trend,and the decline in the study group was more significantly(P<0.05).3.There was no significant difference in the preoperative Ramsay scores between the two groups(P>0.05).The two groups were significantly increased at 12 h and 24 h after surgery,and the scores of 48 h,72h,and 96 h showed a downward trend,and the decline in the study group was more significantly(P<0.05).4.There was no difference in IL-6,CRP,TNF-α comparison between the two groups before operation(P>0.05).Both groups increased significantly at 12 h and 24 h after operation,and decreased at 48 h,72h and 96h(P<0.05),and the decrease in the study group was even more significantly(P<0.05).5.The scores of the EORTC-QLQ-C30 scale at 96 h in the study group were significantly better than those in the control group(P<0.05).6.The FVC,FVC%,FEV1,FEV1/FVC,FEV1%,MVV,PEF,TLCO and TLCO% of the two groups were significantly better than those of the control group at 96 h after operation(P<0.05).7.There was no statistical difference in the preoperative STAI and PSQI scores between the two groups(P>0.05).The STAI and PSQI scores of the two groups increased at 96 h after operation(P<0.05).The STAI and PSQI scores of the study group were lower than those of the control group at 96 hours after operation(P<0.05).8.In the control group,there were 2 cases of dizziness,1 case of respiratory depression,and 1 case of itching.The adverse reaction rate was 13.33%(4/30);the study group had 1 case of dizziness and 1 case of itching,and the adverse reaction rate was 6.67%(2/30);there was no statistical difference in the incidence of adverse reactions between the two groups(χ~2=0.741,P=0.389).Conclusion:The application of pregabalin combined with SAPB in patients with thoracoscopic radical resection of lung cancer can reduce the level of serum inflammatory factors,obtain good analgesia and sedative effects,promote patients’ sleep improvement,reduce their anxiety,and improve the short-term quality of life after surgery,meanwhile,It has a certain positive significance for speeding up postoperative recovery.