Objective  To evaluate the effect of general anesthesia combined with type Ⅱ thoracic nerve block on the perioperative stress response in patients undergoing modified radical mastectomy.

  Methods  Sixty female patients enrolled in Tianjin Medical University Cancer Institute and Hospital from Jannary 2018 to Maay 2019 undergoing radical mastectomy with ASA physical status Ⅰ-Ⅱ were randomly assigned into two groups (n=30) as follows:general anesthesia combined with type Ⅱ thoracic nerve block (group P) and general anesthesia group (group G). Induction via conventional anesthesia was performed for both groups. In group P, Pecs Ⅱ was conducted under ultrasound guidance after anesthesia induction. Venous blood samples were obtained prior to anesthesia induction (T₀), after operation (T₁), 24 hours post-surgery (T₂), 48 hours post-surgery (T₃), respectively. Serum levels of cortisol (Cor), interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor (TNF-α) were measured. Postoperative pain at rest was assessed using visual analog scale(VAS) scores once upon arrival in the postoperative intensive care unit (PICU) and at 2, 6, and 12 hours after the operation.

  Results  57 out of 60 patients completed this study. The Cor level of group P (24.50±2.72) is lower than group G (29.88±2.29) at the time T₁. The levels of IL-6, IL-10 and TNF-α of group P were lower than group G at the time of T₁ and T₂ (P < 0.05). The VAS scores of group P were significantly lower than group G during PICU and at 2, 6 hours after surgery (P < 0.05).

  Conclusion  This study therefore postulates that the combination of general anesthesia with typeⅡthoracic nerve block can effectively reduce the perioperative stress response in patients undergoing modified radical mastectomy.