Effect Of Different Analgesic Drugs Combined With Intercostal Nerve Block On Single-Hole Thoracic Cavity In Elderly Patients Of Recovery Period After Radical Resection Of Lung Cancer Under Microscope

Objective: To observe the effect of different analgesics combined with intercostal nerve block on the recovery period of elderly patients after single-hole thoracoscopic radical resection of lung cancer.Methods: Ninety elderly patients with lung cancer undergoing single-hole thoracoscopic radical surgery,aged 65-80 years old,regardless of sex,were randomly divided into three groups(n=30 cases).Group A: 10 ml of 0.9% sodium chloride injection and 5ml of 1%ropivacaine were diluted into 15 ml of 0.33% ropivacaine to block the intercostal nerve.B:The intercostal nerve was blocked with 0.33% ropivacaine 15ml(the same proportion as group A),and oxycodone hydrochloride 0.1mg/kg was injected intravenously.C: The intercostal nerve was blocked with 0.33% ropivacaine 15m1(the same proportion as group A),and Dezosin 0.1mg/kg was injected intravenously.In each group,the intercostal nerves T4,T5 and T6 were blocked under the direct vision of thoracoscope,and each intercostal nerve was injected with 5 ml of 0.33% ropivacaine.At the same time,in groups B and C,oxycodone hydrochloride 0.1 mg/kg and diazosine 0.1 mg/kg were respectively given,and diluted to 1 mg/ml with 0.9% sodium chloride injection,and slowly injected intravenously within 1-2 minutes.The recovery time of spontaneous respiration,the time of opening eyes and the time of extubation of the three groups of patients after the operation were compared.The visual analogue score(VAS)of the three groups of patients immediately after extubation,2h,6h,12 h and 24 h after extubation,and the number of adverse reactions such as nausea,vomiting,dizziness,respiratory depression,and Ramsay sedation score were observed;The comfort score(BCS)was used to observe the pain of patients at rest,cough and deep breathing immediately after extubation,2h,6h,12 h and 24 h after operation,and to evaluate the comfort state of patients.Results: There was no statistical difference in general clinical data and intraoperative data among the three groups(P>0.05);Compared with group A and group C,the recovery time of spontaneous respiration,the time of calling and opening eyes,and the time of extubation in group B were significantly shortened after the operation(P<0.05);Compared with VAS scores of three groups at different time points after operation,the scores of group B were significantly lower than those of group A and group C immediately after extubation,2h,6h,12 h and 24 h after operation(P<0.05);The VAS score of Group C was significantly lower than that of Group A immediately after extubation and at 2h,6h and 12 h after operation(P.The number of patients in the three groups who needed additional drugs after surgery was statistically analyzed.The results showed that when the VAS score of group A was≥5,the incidence of sufentanil needed to be added was 40%,the incidence of oxycodone needed to be added in group B was3.3%,and the incidence of diazepine needed to be added in group C was 20%.Compared with the incidence of additional drugs in group A and group C,the incidence of additional drugs in group B was significantly lower(P<0.05).Compared with the incidence of additional drugs in Group A,the incidence in Group C was lower(P<0.05).Ramsay scores of patients in group B were significantly better than those in group A and group C immediately after extubation and 2h and 6h after operation(P<0.05).Ramsay scores of patients in three groups at 12 h and 24 h after operation were compared(P>0.05).Compared with group A and group C,the BCS score of patients in group B was higher(P;Compared with group A,patients in group C were more comfortable(P;The BCS score of group A was compared with that of group C 24 hours after operation(P>0.05).There were 3 patients in group A,5 patients in group B and 10 patients in group C.Compared with group C,the incidence of nausea in group A and group B was lower(P<0.05);Compared with group B,the incidence of nausea in group A was lower(P<0.05).There were 1 case of vomiting in group A,2 cases in group B,and 7 cases in group C.Group A and B were compared with group C(P<0.05).There were 2 cases of dizziness in group A,4 cases in group B and 5 cases in group C(P>0.05);No respiratory depression occurred in the three groups.Conclusion: Hydroxycodone combined with intercostal nerve block has slight respiratory inhibition,provides better postoperative analgesia,and the effect is better than that of diazosine and simple nerve block group.At the same time,it improves the sedation state and comfort of the elderly patients during the recovery period,and enhances the satisfaction of the elderly patients.