Effect of ultrasound-guided ropivacaine internal branch block on the functional rehabilitation after laryngeal carcinoma resection

Objective To investigate the effects of ultrasound-guided ropivacaine internal branch block on the functional rehabilitation after laryngeal carcinoma resection.

Methods Seventy-six patients with laryngeal cancer were randomly divided into the control group (38 cases) and observation group (38 cases). All patients were treated with laryngeal carcinoma resection under supportive laryngoscope. The control group received conventional anesthesia during the operation, while the observation group was anesthetized by ultrasound-guided ropivacaine block of the internal branch of the superior laryngeal nerve on this basis. Both groups were observed until 48 hours after operation (T₅). The dosages of anesthetic drugs and vasoactive drugs used in two groups and occurrence of adverse reactions during the postoperative observation period were statistically analyzed. The vital signs at the time of entering the room (T₀), immediately after tracheal intubation (T₁), 30 minutes after skin incision (T₂) and leaving the room (T₃), stress responses and inflammatory indicators at T₀ and after 24 hours of operation (T₄), and functional recovery at T₅ were compared between two groups.

Results The dosage of remifentanil and propofol in the observation group was lower than those in control group (P ＜ 0.05). At T₀, T₁, T₂ and T₃, the HR increased first and then decreased (P ＜ 0.05). In the control group, the SBP and DBP at T₁, T₂ and T₃ were higher than those at T₀, the SBP at T₂ was lower than that at T₁, and the DBP at T₃ was lower than that at T₁ (P ＜ 0.05). In the observation group, the SBP at T₂ and T₃ was lower than that at T₁, the DBP at T₂ was lower than that at T₁, the DBP at T₁ was higher than that at T₀, and the DBP at T₃ was higher than that at T₂ (P ＜ 0.05). The HR and SBP at T₁, T₂ and T₃ in the observation group were lower than those in control group, and the DBP at T₁ and T₂ in the observation group were lower than those in control group (P ＜ 0.05). The serum levels of Cor, ACTH, IL-6 and CRP in the two groups at T₄ were higher than those at T₀, but whose in the observation group were lower than those in control group (P ＜ 0.05). The scores of role, society, body, emotion and knowledge in the two groups at T₅ were higher than those at T₀, and the scores in the observation group were higher than those in the control group (P ＜ 0.05). During the postoperative observation period, there was no statistical significance in the incidence of total adverse reactions between two groups (P ＞ 0.05).

Conclusions Ultrasound-guided ropivacaine block of the internal branch of the superior laryngeal nerve can reduce the use of anesthetic drugs in patients with laryngeal cancer resection, improve the vital signs of patients, reduce the body's stress and inflammatory responses, promote the functional recovery of patients, have a better anesthetic effect, and at the same time will not increase the occurrence of adverse reactions.