Application Of Ultra Sound-guided Thoracic Paravertebral Nerve Block In Breast Conserving Surgery

Objective: To investigate the application of ultrasound-guided thoracic paravertebral nerve block in breast conserving surgery and effects on ERAS.Methods:76 female patients undergoing elective breast conserving surgery with ASA I-II were randomly divided into two groups with 38 cases in each group.The general anesthesia group(Group G)completed breast-conserving surgery by general anesthesia.The thoracic paravertebral nerve block group(group T)completed breast conserving surgery with ultrasound-guided paravertebral nerve block anesthesia.groups G was treated with intravenous patient-controlled analgesia after operation.The blood pressure(systolic/ diastolic)and heart rate of the two groups before anesthesia(T1),intubation(group G)/puncture(group T)(T2),before skin incision(T3),5 minutes after skin incision(T4)and leaving the operating room(T5)after surgery,The amount of sufentanil used during the operation,anesthesia cost were recorded.the visual analogue score(VAS)both during resting time and cough time at 1,2,4,8,12,24,36,48 h after operation were recorded.The recovery time of diet,the first ambulation time after operation,and postoperative pain-related complications,such as postoperative nausea and vomiting,dizziness,respiratory depression,skin pruritus and rash.Result:There was significant difference between group G and group T at T2,T3 and T4(P<0.05),but there was no significant difference between T1 and T5(P > 0.05).Compared with group G,the dosage of sufentanil in group T was decreased,and the difference was statistically significant(P < 0.05).Compared with group G,the anesthesia cost in group T was decreased,and the difference was statistically significant(P < 0.05).visual analogue score(VAS)score(resting time / cough time)was lower in group T than in group G at 1,2,4,8 hours after operation,the difference was statistically significant(P<0.05),but there was no statistical significance at 12,24,36,48 hours after operation(P > 0.05).Compared with group G,the recovery time of drinking in group t was shortened,and the difference was statistically significant(P < 0.05).Compared with group G,group T had shorter time to resume eating after operation,and the difference was statistically significant(P < 0.05).Compared with group G,group T had shorter first ambulation after operation,and the difference was statistically significant(P < 0.05).There was no statistical difference between group T and group G in the occurrence of postoperative pain-related complications,such as postoperative nausea,vomiting,dizziness,respiratory depression,skin pruritus and rash(P>0.05).Conclusion:Ultrasound-guided paravertebral nerve block can be safely and effective applied to in breast conserving surgery and promote the rapid recovery of patients.