Effect Of Paravertebral Nerve Block On Acute Pain And The Incidence Of Chronic Pain After Radical Resection Of Open Esophagus Cancer

Objective:To investigate the effect of paravertebral nerve block combined with multimodal analgesia on the incidence of acute pain and the incidence of chronic pain after radical resection of open esophagus cancer Methods:Inclusion of 100 patients undergoing open radical surgery for esophageal cancer.Inclusion criteria: 25 to 70 years old,BMI 20-28 kg / m2,ASAI ~ II.exclusion criteria:infection at the puncture site?coagulopathy?neurotransmission disease?refusal partner.100 patients were randomly divided into two groups:50 patients in thoracic paravertebral nerve block combined with multimodal analgesia group(TM group);50 patients in multimodal analgesia group(M group);In group TM,10 ml of 0.375% ropivacaine was injected into the thoracic paraspinal space at the T6 and T9 levels of the surgical side of the patient respectively after induction of general anesthesia,total of 20 ml;In group M,patients were not treated with nerve block after induction;At 15 miutes before the operation,each patient was given flurbiprofen 50 mg and dexamethasone 5mg.A vein-controlled analgesia pump with 100ug/100 ml sufentanil + dizocine 20 mg+ondansetron 12 mg was used at 15 miutes before the end of operation;Record the number of analgesic pump presses and the amount of sufentanil within 48 hours after surgery.Evaluation the exercise VAS pain scores at 2h,4h,8h,16 h,24h,and 48 h after surgery,patients with pain score greater than 4 are not included in the study;Three months later,record exercise VAS pain score,the incidence of neuropathic pain,the State-Trait Anxiety Scale(STAI)and the Pittsburgh Sleep Quality Index(PSQI)score by telephone follow-up patient,calculate the incidence of chronic pain;Results::The the number of analgesic pump presses and the amount of sufentanil within 48 hours after surgery were significantly lower than those in the M group(P<0.05).The resting VAS pain score,neuropathic pain incidence,STAI and PSQI scores three months latter in the TM group were significantly lower than those in the M group(P<0.05).The incidence of chronic pain in the TM group were lower than those in the M group(P<0.05).Conclusion:Preoperative single thoracic paravertebral nerve block combined with multimodal analgesia can significantly relieve acute postoperative pain and reduce the incidence of chronic pain in patients undergoing radical resection of esophageal cancer under thoracotomy improve long-term quality of life.