STRESS MARKERS IN VAGOSYMPATHETIC BLOCKADE IN THORACIC SURGERY
DOI:
https://doi.org/10.11603/2414-4533.2025.4.15740Keywords:
regional anesthesia, cortisol, adrenocorticotropic hormone, interleukin-6, endothelin-1, lung resectionAbstract
The aim of the work: to determine the effect of vagosympathetic blockade on the dynamics of stress markers in patients before and after surgery in thoracic surgery.
Materials and Methods. The article investigates the effect of vagosympathetic blockade (VSB) on the intensity of the stress response in patients who underwent resection surgery on the lungs. The dynamics of stress markers were studied: neuroendocrine markers – cortisol and adrenocorticotropic hormone (ACTH) levels; inflammatory markers – interleukin-6 (IL-6) levels; vascular and endothelial markers – endothelin-1 (ET-1) levels. Depending on the use of VSB, patients aged 30–45 years were divided into two groups. Statistical analysis of the results was performed using Statistica 13.0 software (StatSoft Inc., USA) and Microsoft Excel. Data were tested for normality of distribution using the Shapiro-Wilk test. To compare two independent samples, the Student’s t-test or the Mann – Whitney U-test was used, depending on the type of distribution. Results were considered significant at p<0.05.
Results. It was found that patients who received only general anesthesia with controlled mechanical ventilation (CMV) had a significant increase in cortisol, ACTH, IL-6, and ET-1 levels on the 1st postoperative day with a slight tendency to decrease on the 3rd postoperative day. It was shown that the use of VSB in combination with total intravenous anesthesia and controlled mechanical ventilation significantly reduced cortisol, ACTH, IL-6, and ET-1 levels compared with the control group, where only general anesthesia was used. On the 7th postoperative day, the levels of these biomarkers in patients with general anesthesia remained higher than normal, which indicates a prolonged stress and inflammatory response and incomplete adaptation processes. At the same time, in the group with VSB, a more pronounced decrease in cortisol, ACTH, IL-6 and ET-1 levels was observed, with the studied indicators approaching the reference values.
Conclusions. Vagusympathetic blockade is effective in the prevention of acute post-thoracotomy pain syndrome and can be used as an alternative method in the presence of contraindications for thoracic epidural anesthesia.
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