Thoracic Paravertebral Nerve Block Combined With Laryngeal Mask Application In Pulmonary Bullae Operation

Objective:To evaluate the feasibility and safety of ultrasound-guided thoracic paravertebral nerve block combined with Spontaneous Breathing anesthesia with laryngeal mask in thoracoscopic resection of pulmonary bullae.Methods:Sixty patients undergoing thoracoscopic bullectomy were randomly divided into two groups.In Group A,conventional double-lumen endobronchial catheters were used to achieve single-lung ventilation during surgery.In group B,the thoracic paravertebral nerve block was guided by ultrasound and the laryngeal mask was placed after vein induction with propofol.Muscle relaxant was not used during the operation.The patient’s spontaneous breathing was retained and only the sevoflurane was used to maintain the depth of anesthesia.Under the spontaneous breathing state,the operative lung collapses due to atmospheric pressure and elastic retraction of the lung.Postoperative PCIA analgesia was used in both groups.The lowest value of SpO₂ during surgery,the maximum value of PETCO₂,the operative field exposure score,anesthesia time,operation time,recovery time,postoperative hospital stay and hospitalization costs were recorded.Observe the presence or absence of respiratory depression and cough response in the operation and observe postoperative nausea and vomiting,throat discomfort,and hoarseness.Results::There was no significant difference in the values of SpO₂,PETCO₂,surgical field exposure,anesthesia time and operation time between the two groups.There was no respiratory depression in group B.Compared with group A,awakening time and postoperative hospital stay were significantly shorter in group B,and hospitalization costs were significantly lower（P<0.05）.The incidence of nausea and vomiting,postoperative sore throat and hoarseness was significantly lower in group B than in group A（P<0.05）.Conclusion:Ultrasound guided thoracic paravertebral nerve block combined with Spontaneous Breathing anesthesia with laryngeal mask can be safely used in thoracoscopic resection of pulmonary bullae and can accelerate postoperative recovery.