Analgesic Effect Of General Anesthesia And Ultrasound-guided Paravertebral Block In Radical Thoracic And Laparoscopic Esophagectomy Patients

ObjectiveTo analyze the effect of general anesthesia combined with ultrasound-guided paravertebrospinal nerve block(USG-PVB)in thoracoscopic radical resection of esophageal carcinoma(TLE)and its effect on postoperative recovery.MethodsEighty-two patients with TLE in our hospital were selected for this study.The patients were enrolled in the group from June 2018 to June 2019.ASA was divided into two groups: control group(41 cases)and observation group(41 cases).The former group received general anesthesia and the latter group received general anesthesia combined with usg-pvb.The two groups received the same general anesthesia method The observation group was given usg-pvb before induction of general anesthesia.The following indexes were recorded and compared between the two groups: the amount of vasoactive drugs,anesthetics and drugs used in the anesthesia recovery room(PACU);the stay time,extubation time and restlessness during the recovery period of PACU;the visual analog pain score(VAS)at the time of PACU exit,recovery and each period after operation;the MMSE test at the 1st day before operation and the 7th day after operation;the living after operation Hospital time;Preoperative 1 d and post-operative 1 w Simple Mental State Examination Scale Score,one week after surgery;the incidence of postoperative cognitive impairment(POCD).ResultsThere was no significant difference(P>0.05)between the two groups in terms of age,gender,ASA classification,BMI,preoperative complications and other baseline data.In terms of the amount of vasoactive drugs and anesthetics,the amount of propofol,sufentanil and remifentanil in the observation group was significantly less than that in the control group(P<0.05),There was no significant difference in the dosage of nicardipine,epinephrine and ephedrine between the two groups(P>0.05);the time of extubation in the observation group was significantly shorter than that in the control group(P<0.05),and the incidence of PACU agitation was significantly lower than that in the control group(P<0.05),the dosage of anesthesia drugs(sufentanil)in PACU was significantly less than that in the control group(P<0.05),and the stay time and hospitalization time of PACU were significantly shorter than those in the control group(P Compared with the control group,the VAS scores of the observation group were significantly lower at PACU,awakening and 1,2,3 and 5 days after operation(P<0.05);there was no significant difference(P>0.05)between the two groups in the MMSE score group(P>0.05),the observation group was slightly higher than the control group(P>0.05)in the postoperative group(P>0.05),There was no significant difference between preoperative and postoperative 1w scores in the MMSE group(P>0.05).The score of 1 w was lower than that of 1 d(P<0.05);the incidence of POCD in the observation group was 7.32%,the incidence of POCD in the control group was 17.07%,the incidence of POCD in the observation group was lower than that in the control group(P>0.05).ConclusionThe use of general anesthesia combined with usg-pvb in patients receiving tle can significantly reduce the dosage of perioperative anesthesia and analgesics,and the effect of anesthesia and analgesics is better than that of general anesthesia alone,and the patients’ postoperative pain will be more effectively relieved,and the early postoperative restlessness will be reduced,and the length of stay will also be shortened It is helpful for the quick recovery after operation.