Analgesic Effect of Oliceridine Combined with Thoracic Paravertebral Nerve Block in Elderly Patients Undergoing Lung Cancer Resection and Its Impact on Neuroinflammation and Cognitive Function

[ Objective ]: To investigate the analgesic effect of Oliceridine combined with thoracic paravertebral block (TPVB) in radical surgery for lung cancer in elderly patients and its impact on neuroinflammation and postoperative cognitive function, aiming to provide new therapeutic strategies for postoperative pain management and cognitive function protection in elderly lung cancer patients. [ Methods ]: Eighty elderly patients who underwent thoracotomy for radical lung cancer surgery at Xuzhou First People's Hospital between October 2024 and August 2025 were selected and randomly divided into a control group and an experimental group, with 40 patients in each group. The control group received TPVB combined with conventional intravenous patient-controlled analgesia, while the experimental group received Oliceridine in addition to TPVB for intravenous patient-controlled analgesia. Postoperative pain was assessed using the Visual Analog Scale (VAS), and the levels of inflammatory mediators such as matrix metalloproteinase-9 (MMP-9), lipoprotein-associated phospholipase A2 (Lp-PLA2), interleukin-6 (IL-6), and tumor necrosis factor-α(TNF-α) in plasma were measured at different time points postoperatively. Cognitive function was evaluated using the Montreal Cognitive Assessment (Moca), and the occurrence of adverse reactions was recorded in both groups. The VAS scores of the experimental group at 6 hours, 12 hours, 24 hours, and 48 hours postoperatively were significantly lower than those of the control group (P<0.05), indicating that the combined regimen has a good analgesic effect. At all postoperative time points, the plasma levels of MMP-9, Lp-PLA2, IL-6, and TNF-α in the experimental group were significantly lower than those in the control group (P<0.05), indicating that this regimen can effectively inhibit postoperative neuroinflammatory responses. On the 7th day post-surgery, the Moca score of the experimental group was significantly higher than that of the control group (P<0.05), suggesting that this combined regimen has a protective effect on postoperative cognitive function. Additionally, the incidence of adverse reactions in the experimental group was significantly lower than that in the control group (P<0.05). [ Conclusion ]: Oliceridine combined with TPVB demonstrates significant analgesic efficacy in radical surgery for elderly lung cancer patients, effectively inhibits postoperative neuroinflammatory responses, provides protective effects on postoperative cognitive function, and exhibits good safety, indicating its clinical value for promotion.