Effects of liposomal bupivacaine for erector spinae plane block on perioperative immune function and analgesia in thoracoscopic lung cancer surgery.

IF 2.9 3区医学 Q2 ONCOLOGY

American journal of cancer research Pub Date : 2025-08-25 eCollection Date: 2025-01-01 DOI:10.62347/SQHE7607

Chenghai Wang, Baosheng Zheng, Changsen Lin, Xikai Li, Ruxia Li, Luxi Zhao, Shijin Liu, Huimei Hao

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引用次数: 0

Abstract

Objective: To assess the immunomodulatory and analgesic effects of liposomal bupivacaine compared to ropivacaine on erector spinae plane block (ESPB) for patients undergoing thoracoscopic lung cancer surgery.

Methods: This retrospective study included 260 patients undergoing thoracoscopic lung cancer surgery. Patients were divided into two groups based on anesthesia methods: the liposomal bupivacaine group (n = 134) and the ropivacaine group (n = 126). Both groups received general anesthesia followed by ESPB. Perioperative inflammatory markers (IL-6, TNF-α, CRP), immunoglobulins (IgA, IgG, IgM), and analgesic outcomes (Numerical Rating Scale (NRS) scores) were measured at various postoperative time points. Cellular inflammatory markers, including white blood cell (WBC) counts and neutrophil percentages, were also assessed. Tumor markers (galectin-3 (Gal-3), carbohydrate antigen 125 (CA125), cytokeratin 21-1 fragment (CY-FRA21-1), soluble programmed death ligand-1 (sPD-L1)) were analyzed at 3-month follow-up.

Results: The liposomal bupivacaine group exhibited significantly reduced inflammatory responses with lower levels of IL-6 (P = 0.005), TNF-α (P = 0.007), and CRP (P = 0.01) at 12-72 hours postoperatively. Immunoglobulin levels were better preserved in this group (IgA P = 0.007, IgG P = 0.016, IgM P = 0.033). Analgesia outcomes were superior, with lower NRS scores at 36 h (P = 0.002) and 72 h (P = 0.006). Cellular inflammatory markers, including WBC counts and neutrophil percentages, were also significantly reduced (P < 0.05). At the 3-month follow-up, the liposomal bupivacaine group showed significantly lower levels of tumor markers, particularly sPD-L1 (all P < 0.001).

Conclusions: Liposomal bupivacaine for ESPB enhances both immunoprotective effects and postoperative analgesia in thoracoscopic lung cancer surgery.

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布比卡因脂质体对胸腔镜肺癌手术围术期免疫功能及镇痛的影响。

目的：比较布比卡因脂质体与罗哌卡因对胸腔镜肺癌手术患者竖脊肌平面阻滞（ESPB）的免疫调节和镇痛作用。方法：回顾性研究260例胸腔镜下肺癌手术患者。根据麻醉方式将患者分为布比卡因脂质体组（134例）和罗哌卡因组（126例）。两组均行全身麻醉后ESPB。在术后不同时间点测量围手术期炎症标志物（IL-6、TNF-α、CRP）、免疫球蛋白（IgA、IgG、IgM）和镇痛效果（数值评定量表（NRS）评分）。细胞炎症标志物，包括白细胞（WBC）计数和中性粒细胞百分比，也被评估。随访3个月，分析肿瘤标志物（半凝集素-3 （Gal-3）、碳水化合物抗原125 （CA125）、细胞角蛋白21-1片段（CY-FRA21-1）、可溶性程序性死亡配体-1 (sPD-L1)）。结果：布比卡因脂质体组术后12-72小时炎症反应明显减轻，IL-6 （P = 0.005）、TNF-α (P = 0.007)、CRP （P = 0.01）水平均降低。免疫球蛋白水平保存较好（IgA P = 0.007, IgG P = 0.016, IgM P = 0.033）。镇痛效果较好，36 h （P = 0.002）和72 h （P = 0.006）时NRS评分较低。细胞炎症标志物，包括白细胞计数和中性粒细胞百分比也显著降低（P < 0.05）。在3个月的随访中，布比卡因脂质体组肿瘤标志物水平显著降低，尤其是sPD-L1水平（均P < 0.001）。结论：布比卡因脂质体可增强胸腔镜肺癌手术中ESPB的免疫保护作用和术后镇痛作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of cancer research ONCOLOGY-

自引率

3.80%

发文量

263

期刊介绍： The American Journal of Cancer Research (AJCR) (ISSN 2156-6976), is an independent open access, online only journal to facilitate rapid dissemination of novel discoveries in basic science and treatment of cancer. It was founded by a group of scientists for cancer research and clinical academic oncologists from around the world, who are devoted to the promotion and advancement of our understanding of the cancer and its treatment. The scope of AJCR is intended to encompass that of multi-disciplinary researchers from any scientific discipline where the primary focus of the research is to increase and integrate knowledge about etiology and molecular mechanisms of carcinogenesis with the ultimate aim of advancing the cure and prevention of this increasingly devastating disease. To achieve these aims AJCR will publish review articles, original articles and new techniques in cancer research and therapy. It will also publish hypothesis, case reports and letter to the editor. Unlike most other open access online journals, AJCR will keep most of the traditional features of paper print that we are all familiar with, such as continuous volume, issue numbers, as well as continuous page numbers to retain our comfortable familiarity towards an academic journal.