Protective effect of paravertebral nerve block combined with general anesthesia on postoperative liver injury in patients undergoing laparoscopic hepatectomy

Objective‍ To investigate the protective effect of paravertebral nerve block combined with general anesthesia on liver injury after laparoscopic hepatectomy (LH). Methods‍ ‍A randomized controlled trial was conducted on 51 patients undergoing LH in our hospital between April and August 2024. They were randomly divided into control group (n=25, general anesthesia) and paravertebral block group (n=26, paravertebral nerve block before general anesthesia induction). Beside anesthesia, they received same other medical treatment. The following indicators were compared between the 2 groups, that is, serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and albumin (ALB), and systemic-immune inflammation (SII) index within 7 d before and on the 1st and 2nd days after surgery; heart rate and mean arterial pressure (MAP) before anesthesia induction (T1), before pneumoperitoneum establishment (T2), pneumoperitoneum establishment (T3), and at the first hilar occlusion (T4); usages of intraoperative norepinephrine, sevoflurane, and analgesic drugs 24 h postoperatively; as well as operation time, extubation time, and lengths of postanesthesia care unit (PACU) stay and hospital stay.Results‍ The paravertebral block group had significantly lower ALT on the 1st day after surgery [178.40 (126.55, 325.86) vs 292.20 (197.20, 468.95) U/L], SII on the 2nd day after surgery [704.13 (486.61, 1 078.59) vs 1 075.09 (753.80, 1 614.38)], and amount of analgesic drugs in 24 h after surgery [29.70 (27.37, 32.07) vs 31.99 (28.92, 40.81) mg], and decreased MAP level at T3 and T4, early extubation, and shorter lengths of PACU stay and hospital stay when compared with the control group (all P<0.05). Conclusion‍ Paravertebral nerve block combined with general anesthesia can reduce inflammatory responses, relieve postoperative pain, stabilize hemodynamics for patients undergoing LH, and thereby alleviate postoperative liver injury in them.