Effect of sevoflurane combined with intercostal block on postoperative pulmonary function, opioid consumption, and stress response in lung cancer surgery patients.

Abstract

Objective: To investigate the efficacy of sevoflurane combined with intercostal block in lung cancer surgery.

Methods: A retrospective analysis was conducted on 252 patients who underwent lung cancer surgery between January 2020 and December 2023. Patients were divided into two groups: the sevoflurane with intercostal block group (Group S, n = 108) and the propofol group (Group P, n = 144). Anesthesia protocols involved sevoflurane and intercostal nerve block or propofol. Postoperative pulmonary function, opioid consumption, stress response, and cognitive effects were compared between the two groups.

Results: The VAS scores were significantly lower in Group S at postoperative 2 h (1.96 ± 0.52 vs 2.15 ± 0.56, P = 0.005) and 24 h (3.84 ± 0.95 vs 4.14 ± 0.98, P = 0.015), indicating superior pain management. Group S also showed better preservation of lung function, with higher FEV1 values at postoperative 2 hours (1.49 ± 0.29 L vs 1.36 ± 0.65 L, P = 0.033) and 24 hours (1.59 ± 0.39 L vs 1.45 ± 0.45 L, P = 0.012). Opioid consumption was lower in Group S at both postoperative 24 h (1307.52 ± 259.41 µg vs 1742.26 ± 253.12 µg, P < 0.001) and 48 h. Cognitive function was better preserved immediately post-surgery in Group S (26.03 ± 4.42 vs 24.14 ± 5.28, P = 0.003). However, adverse reactions like nausea were more common in Group S (9.26% vs 2.78%, P = 0.026).

Conclusion: Sevoflurane combined with intercostal block outperforms propofol in enhancing postoperative pulmonary function, reducing opioid reliance, and modulating stress responses in lung cancer surgery patients.