Effects Of Intercostal Nerve Block Combining With Vein Analgesia On Immune Function Of T Cell In Radical Surgery Of Lung Cancer

Objective To investigate effect of intercostal nerve block composite veinanalgesia on cellular immune unction of T of lung cancer patients by detectingplasma peripheral CD4+%, CD8+%and interferon γ (IFN-γ) concentration.Methods Sixty lung cancer patients, classified as ASA physical status Ⅰ~Ⅱ,scheduledfor elective lung resection were randomly divided into two groups:Intercostal nerve block group (group L) and Non intercostal nerve block group(group N).In group L,patients received intercostal nerve block off chest surgerypatients in group N not received intercostal nerve block.Paints in two groups werereceived patient-controlled intravenous analgesia(PCIA) postoperatively;.Pain andsedation intensity were assessed at1h after the end of surgery(T1)24h after the endof surgery(T2),48h after the end of surgery using a numerical rating scale(NRS).Venous blood samples were taken before the induction of an-esthesia(T0)and atT1,T2,T3.The percentage of CD4+T lymphocytes and CD8+T lymphocyteswere quantified by using Flow Cytometry.The concentration of IFN-γ was detectedby using enzyme linked immunosorbent assay（ELISA).Results (1) Effects of analgesia The VAS scores at T2were significantlyhigher than at T1in two groups (P<0.01).The VAS scores at T2were significantlyhigher than at T3in two groups (P<0.01). The Ramsay scoresat T2and T3weresignificantly lower than at T1in two groups (P<0.01).(2)Changes of CD4+and CD8+T lymphocyte subset The percentage of CD4+in group L was hinger than ingroup N at T1(P<0.05). Compared with the values at T0, percentage of CD4+fromTIto T2in group L decreased (P<0.05).In group N, the percentage of CD4+wasentirely decreased at T1,T2and T3compared with T0(P<0.05).(3)Changes of theconcentration of IFN-γ The concentration of IFN-γin group L was higher thangroup N at T2(P<0.05). In group L, the concentration of IFN-γwas significantlyhinger at T2than T0(P<0.01),higher than T1(P<0.05).Conclusion The intercostal block with ropivacaine plays a protective role inthe cellular immune function of the patients who had accepted lung resection aftersurgery.Thanks to its clinical operation was relatively simple and high feasibility,so it is worthy to spread.