Effect Of Transversus Abdominis Plane Block On Immune Function And Rapid Recovery After Laparoscopic Cervical Cancer Radical Surgery

Objective:To evaluate the effects of ultrasound-guided transversus abdominal plane block on the immune function and the clinical effect of rapid recovery after laparoscopic radical cervical cancer surgery.Methods:Sixty patients who underwent elective laparoscopic radical resection of cervical cancer at the First Affiliated Hospital of Nanchang University from June 2018 to June2019 were selected.They were randomly divided into transversus abdominis plane block combined with self-controlled intravenous analgesia group?T group?and simple self-controlled intravenous analgesia group?C group?,30 cases in each group.In group T,bilateral transversus abdominis plane block was performed with 0.375%ropivacaine under ultrasound guidance.In both groups,intravenous self-controlled analgesia was performed after the surgery.The general condition of the two groups of patients was recorded.The VAS pain scores in postoperative 1st,4th,12th,and 24th hours at rest and in activity?Knee bend?were evaluated and recorded.And observe the occurrence of adverse reactions during recovery.The number of compressions and adverse reactions of the analgesic pump self-controlled additional dose within 24hours after operation were recorded.The levels of IFN-?and IL-4 were detected at T₀?1 day before surgery?,T₁?1 day after surgery?and T₂?3 days after surgery?.IFN-?/IL-4 levels were used to assess the shift of Th1/Th2 cell.The QoR-40 scale was used to assess postoperative recovery.Result:The VAS scores in 1st,4th and 12th hours at rest and in activity in group T were significantly lower than those in group C?p<0.05?.The number of analgesic pump presses and the incidence of adverse reactions within postoperative 24 h in group T were also significantly lower than those in group C?p<0.05?.The levels of IFN-?and IL-4 decreased at T₁ and T₂ in both groups compare with T₀?p<0.05?.The IFN-?/IL-4 in the TAP group was significantly higher than that in the control group on the1st day after operation?T₁??p<0.05?.There was no significant difference in the incidence rate of adverse reactions between group T and group C.The body comfort score,emotional state score,psychological support score,pain score and total score of QoR-40 scale in group T were significantly higher than those in group C?p<0.05?.Conclusion:As a part of multimodal analgesia,transversus abdominis plane block can improve the analgesic effect of laparoscopic cervical cancer patients,increase Th1/Th2 ratio and promote the early recovery of immune function and accelerate the rapid recovery of patients,which is worthy of clinical promotion.