Effects Of Ultrasound-guided Transversus Abdominis Plane Block On The Postoperative Analgesia And Immune Function In Gastric Cancer Patients

Objective:This study was to investigate the effects of ultrasound-guided transversus abdominis plane(TAP)block on postoperative immune function in patients with gastric cancer surgery.Methods:A total of 216 patients with gastric cancer undergone gastrectomy at First Affiliated Hospital of Nanchang University were randomly divided into TAP group and the control group.After anesthesia induction and intubation,patients in TAP group were received ultrasound-guided TAP block with 0.35%ropivacaine and0.5%lidocaine(in saline)solution 20ml for each TAP,whereas those in control group received equal volume of saline.The consumption of total general anesthetics,postoperative Visual Analogue Scale,postoperative demand of analgesic and recovery from general anesthesia were observed.The plasmatic levels of Interleukin-2(IL-2),Interleukin-6(IL-6),Interferon-?(IFN-?),the percentage of CD3~+CD28~+T cells,CD3~+CD28~-T cells,CD3~+T cells in all the lymphocytes and that of regulatory T cells in CD3~+T cells were measured at before anesthesia induction,24h and 48h after operation.Results:The consumption of propofol,remifentanil and cisatracurium in TAP group were less than control group(P<0.05).The VAS score at 1,24,48h post-surgery,postoperative analgesic demand,the time of bed rest and the starting time of anus exhausting in TAP group were less than control group(P<0.05).Forty eight hours post-surgery,the levels of IL-2 in TAP group increased,while these in control group decreased(P<0.05).Both of the levels of IFN-?in TAP group at 24h and 48h after surgery were higher than control group(P<0.05).Compared with control group,the ratio of IFN-?/IL-6 was increased,but the percentage of CD3~+CD28~+T cells decreased significantly at 24h after operation(P<0.05).At 24h and 48h after surgery,the percentage of CD3~+CD28~-T cells in TAP group showed a decreasing trend,while that in the control group showed an significant increase(P<0.05).The decreased percentage of CD3~+T cells in TAP group was less than control group(P<0.05).There was no significant difference in the ratio of Treg cells between two groups(P>0.05).Conclusions:Ultrasound-guided TAP block can significantly reduce the consumption of general anesthesia-related drugs in gastrectomy,relieve postoperative pain,protect immune function and promote rehabilitation after gastrectomy surgery.