Study On The Effect Of Single Dose Of Paravertebral Nerve Block Under Direct Vision For Postoperative Analgesia In Patients Undergoing Thoracotomy For Lung Resection

Objective:To explore the effect of singal dose of paravertebral nerve block in direct vision for postoperation analgesia in patients undergoing thoracotomy for lung resection.Methods:Retrospective analysis of patients undergoing electived to thoracotomy for lung resection, those of ASA (American Society of Anesthesiology) Ⅰ-Ⅱ in our hospital between June 2012 and May 2013 were included and divided into two groups: observation group (P) and control group (C).Patients with cardiopulmonary insufficiency or abnormal hepatic and renal function were excluded. Postoperative analgesia in group C was given by intravenous analgesia while group P was given paravertebral nerve block performed by the operator before at the end of surgery using the de visu technique, combined with intravenous analgesia. We compare the visual analog pain scores(VAS) at 24% 48hours postoperation at rest and cough, the rate of supplementary intravenous analgesia and the dose of converted into morphine, postoperative pulmonary complications (atelectasis、pulmonary infection、respiratory failure), oxygenation index (OI) one day after surgery, the postoperative hospitalization days between the two groups. SPSS 13.0 was used for the statistical evaluation, P< 0.05 was considered to be statistically significant.Results:There was no statistically significant difference in operating time, intraoperative blood loss and the extent of pulmonary resection (P> 0.05). Compared with group C,patients in group P had a lower VAS at 24% 48 hours, postoperation at cough (P< 0.05) and postoperative pulmonary complications were lower (P< 0.05), the less need for supplementary intravenous analgesia and the lower dose of analgesic that converted into morphine (P< 0.05), OI in the first day postoperation was better (P< 0.05), the stay of hospitalization postoperation was shorter (P< 0.05). There was no statistically significant difference in VAS at 24% 48 hours postoperation that testing at rest, the rate of admitted to the ICU and the length of ICU stay (P> 0.05).Conclusion:Singal dose of paravertebral nerve block under direct vision combined with intravenous injection for postopersive analgesia in patients undergoing thoracotomy for lung resection carried out to be a better analgesia, with lower pulmonary complications, shorter length of stay postoperation and promoting patients to recover quickly.