Effects of remifentanil general anesthesia combined with thoracic paravertebral nerve block on analgesic effect and immune-inflammatory response in elderly patients undergoing renal cancer surgery
He Jinling
Zhang Yuan
Yun Letian
Wang Lisi
Abstract：Objective To investigate the effects of remifentanil general anesthesia combined with thoracic paravertebral nerve block on analgesic effect and immune-inflammatory response in elderly patients undergoing renal cancer surgery.Methods A total of 146 elderly renal cancer patients undergoing elective retroperitoneal laparoscopic radical nephrectomy at Inner Mongolia People's Hospital from February 2024 to July 2025 were enrolled.They were divided into control group and observation group by random number table method,with 73 cases in each group.The control group received remifentanil-based general anesthesia,and the observation group received remifentanil-based general anesthesia combined with thoracic paravertebral nerve block.The analgesic effect,mean arterial pressure(MAP),heart rate,immune function indexes,natural killer cells and inflammatory factors at different time points,as well as the incidence of adverse reactions were compared between the two groups.Results There were significant inter-group,time and interaction effects in visual analogue scale(VAS)scores at different states between the two groups(all P＜0.05),and the VAS scores at 12 h,24 h and 48 h after operation in the observation group were lower than those in the control group(all P＜0.05).There were signifi-cant inter-group,time and interaction effects in MAP and heart rate at different time points between the two groups(all P＜0.05),and MAP and heart rate at skin incision in the observation group were lower than those in the control group(all P＜0.05).There were significant inter-group and time effects in CD3+,CD4+,CD8+,CD4+/CD8+ratio and natural killer cells at different time points between the two groups(all P＜0.05).At 24 h after operation,the levels of CD3+,CD4+,CD4+/CD8+ratio and natural killer cells in the observation group were higher than those in the control group,while the level of CDs+was lower(all P＜0.05).There were significant inter-group and time effects in inflammatory factors at different time points between the two groups(all P＜0.05),and the levels of inflammatory factors at 24 h after operation in the observation group were lower than those in the control group(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group[6.8％(5/73)vs 5.5％(4/73)](x2＜0.001,P=1.000).Conclusions Remifentanil general anesthesia combined with thoracic paravertebral nerve block has obvious analgesic effect in elderly patients undergoing renal cancer surgery,which can effectively improve immune function,inhibit inflammatory response and enhance the safety of surgery in elderly renal cancer patients.
Keywords：Renal cancerRemifentanilThoracic paravertebral nerve blockAnalgesiaImmune functionInflammatory factors
Publication Date：2026-05-18
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：6( 714-719 )