Application Of Ultrasound-guided Thoracic Paravertebral Nerve Block In Video-assisted Thoracosopic Surgery

Objective To investigate the effect of single-pretreat thoracic paravertebral block?TPVB?of ropivacaine combined with sufentanil on patients'pain and enhanced recovery after surgery?ERAS?that undergoed video-assisted thoracosopic surgery.Methods Sixty patients undergoing lvideo-assisted thoracosopic surgery were randomly divided into three groups:group C received intravenous combined general anesthesia,group T₁ received single-pretreat thoracic paravertebral block of ropivacaine combined with intravenous and general anesthesia,group T₂ recived single-pretreat thoracic paravertebral block of ropivacaine combined with sufentanil united with intravenous and general anesthesia.All groups did not used the postoperative analgesia pump.Tramadol hydrochoride infection?100mg?were required to rescue in subjects of NRS scores>4 after surgery.In addition,we recorded nerve block drug before the operation;the dosage of sufentanil intravenous anesthetics,sufentanil?intravenous+nerve block?and remifentanil intravenous anesthetics during the operation;the NRS scores at 4,6,24,48h after the surgery,whether rescuing analgesia in the first 24 h after surgery,ICU stay and hospital stay after the surgery.Results Compared with group C,the dosage of sufentanil intravenous anesthetics,sufentanil?intravenous+nerve block?,remifentanil intravenous anesthetics during the opreaction,the NRS scores at 4,6 h after the surgery and ICU stay and hospital stay after the surgery in group T₁ and T₂ significantly decreased?p<0.05?.The total dosage of opioids during the operation and the NRS scores at 4,6 h after the surgery in group T₂ significantly decreased than group T₁?p<0.05?.However,the total dosage of sufentanil?intravenous+nerve block?,ICU stay and hospital stay had no significantly differences between group T₁ and T₂.Conclusion Single-pretreat thoracic paravertebral block of ropivacaine combined with sufentanil can reduced the total dosage of opioids and exercised the best analgesic effect.Compared with intravenous combined general anesthesia group that contributed to recovery.However,compared with intravenous combined general anesthesia group that had no effect to postopretie rehabilitation.