Zeng-lang GU, Xiao-jun WANG, Lian-sheng XU. Effect of transversus thoracic muscle plane block on perioperative neurocognitive disorders in patients with valve replacement under cardiopulmonary bypass[J]. Chinese Heart Journal, 2022, 34(4): 444-448. DOI: 10.12125/j.chj.202108016
    Citation: Zeng-lang GU, Xiao-jun WANG, Lian-sheng XU. Effect of transversus thoracic muscle plane block on perioperative neurocognitive disorders in patients with valve replacement under cardiopulmonary bypass[J]. Chinese Heart Journal, 2022, 34(4): 444-448. DOI: 10.12125/j.chj.202108016

    Effect of transversus thoracic muscle plane block on perioperative neurocognitive disorders in patients with valve replacement under cardiopulmonary bypass

    •   AIM  To explore the effect of transversus thoracic muscle plane block on perioperative neurocognitive disorders (PND) in patients with valve replacement under cardiopulmonary bypass (CPB).
        METHODS  One hundred and fifty-six patients with valve replacement under CPB were selected and randomly divided into group A and group B, 78 cases in each group. The patients in group A received general anesthesia and the patients in group B received transversus thoracic muscle plane block before general anesthesia. The total amount of sufentanil in the operation and the pressing times of analgesic pump within 24 hours after operation were compared between the two groups. The VAS scores at rest and at cough at 6h, 12h and 24h after operation were compared between the two groups. Serum TNF-α, IL-6, NSE and S-100β were compared between the two groups before anesthesia (T1), at the end of operation (T2), 6 hours after operation (T3) and 24 hours after operation (T4). The scores of Mini Mental State Examination (MMSE) were compared between the two groups at 1d day before operation and at 1d, 3 d and 7d after operation. The incidence of PND at 1d, 3d and 7d after operation was compared between the two groups.
        RESULTS  The total amount of sufentanil in the operation and the pressing times of analgesic pump within 24 hours after operation in group A were less than those in group B (P<0.05). The VAS scores at rest and at cough in group A were lower than those in group B at 6h, 12h and 24h after operation (P<0.05). At T2, T3 and T4, the serum levels of TNF-α and IL-6 in group A were lower than those in group B (P<0.05). The serum levels of NSE and S-100β in group A were lower than those in group B (P<0.05). The MMSE scores in group A were higher than those in group B at 1, 3 and 7 days after operation (P<0.05). The incidence of PND in group A was lower than that in group B at 1d, 3d and 7d days after operation (P<0.05).
        CONCLUSION  Transversus thoracic muscle plane block effectively inhibits the release of inflammatory cytokines, reduces nerve injury and improves postoperative cognitive function, thus reducing the occurrence of PND for patients with valve replacement under CPB.
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