Effects of nalbuphine and sufentanil on stress response and immune response in patients undergoing thoracoscopic unilateral lobectomy : A randomized controlled trial

Background: According to the statistics of the American Cancer Society in 2024, the incidence of lung cancer ranks second, but its mortality rate ranks first. Thoracoscopy is one of the commonly used surgical methods in recent years. This study was to investigate the effects of nalbuphine on stress response, immune function and analgesic effect in patients after thoracoscopic surgery. Methods This study was a prospective trial of patients after thoracoscopic lung cancer resection. The cohort was randomly divided into two groups : nalbuphine group ( RN group ) and sufentanil group ( RS group ). Thoracic paravertebral nerve block was performed before surgery in both groups. RN group : 0.75% ropivacaine ( 10ml ) + nalbuphine ( 0.2mg / kg ) + normal saline = 20ml. RS group : 0.75% ropivacaine ( 10ml ) + sufentanil ( 0.2µg / kg ) = 20ml. After surgery, all patients were rescued with PCIA. RN group : nalbuphine 2 mg / kg + normal saline = 150 ml, RS group : sufentanil (2 µg / kg ) + normal saline = 150 ml. Results: Compared with RS group, ( 1 ) CD3 in T2 and T3 RN group was higher ( P < 0.05 ). ( 2) ACTH in RN group was lower at T3 ( P < 0.05 ). ( 3 ) IL-6 in RN group was lower at T3 ( p < 0.05 ) ; ( 4 ) compared with RS group, the VAS scores of patients in RN group were significantly lower within 2 hours and 24 hours after operation ( P < 0.05 ). Conclusion : In patients undergoing thoracoscopic lobectomy, nalbuphine can reduce stress response and immunosuppression, reduce postoperative inflammatory response, relieve postoperative rest pain, and facilitate postoperative rehabilitation.