A randomised trial: effects of different anesthesia methods on early perioperative pain sensitivity and cellular immune function in patients undergoing radical mastectomy

• Published in: Gland surgery Vol. 10; no. 7; pp. 2246 - 2254
• Main Authors: Li, Jiacen, Lyu, Qiang, Su, Wenjie, Li, Meiting, Du, Yu, Hu, Yunxia
• Format: Journal Article
• Language: English
• Published: China (Republic : 1949- ) AME Publishing Company 01.07.2021
• Subjects: Original; transversus thoracic muscle plane-pectoral nerves block (TTP-PECS block); Radical mastectomy; pain sensitivity; propofol; cellular immune function
• ISSN: 2227-684X; 2227-8575
• DOI: 10.21037/gs-21-343

This study sought to investigate the effects of transversus thoracic muscle plane-pectoral nerves (TTP-PECS) block combined with propofol anesthesia on early perioperative pain sensitivity and cellular immune function in patients undergoing radical mastectomy. A total of 115 patients who underwent radical mastectomy for breast cancer at our hospital from January 2019 to January 2021 were selected as the study subjects. The patients were allocated to the control group (n=57) or observation group (n=58) using a random number method. The control group was given simple general anesthesia, and the observation group was given TTP-PECS block combined with propofol anesthesia. The recovery time, pain [visual analogue scoring (VAS)] scores, and incidences of adverse reactions were compared between the 2 groups. Hemodynamic indicators [i.e., heart rate (HR), mean arterial pressure (MAP)], stress indicators [i.e., blood glucose (GLU), epinephrine (E), cortisol (Cor)], and the cellular immune function ofthe2 groups before anesthesia (T0), at the end of operation (T1), 1day after operation (T2) and 3days after operation (T3) were recorded. The spontaneous respiration recovery time, time to full wakefulness and the extubation time of the observation group were shorter than those of the control group (P<0.05). The observation group had lower VAS scores than the control group at 2, 8, 12, and 24 h after operation (P<0.05). The levels of MAP, HR, GLU, E and Cor in the observation group at T1, T2, and T3 were lower than those in the control group (P<0.05). Compared to the control group, the observation group had increased cluster of differentiation (CD)3 , CD4 , and CD4 /CD8 cells (P<0.05), but there were no significant differences in CD8 and natural killer (NK) cells between the 2 groups (P>0.05). The incidence of adverse reactions in the observation group was lower than that in the control group (8.62% 24.56%) (P<0.05). TTP-PECS block combined with propofol anesthesia can relieve pain, shorten the recovery time, stabilize the hemodynamic level, and alleviate the stress responses of patients undergoing radical mastectomy with a slight suppression of cellular immune function and high safety. Chinese Clinical Trial Registration Center ChiCTR2100048438.