The Early Analgesic Effect And Evaluation Of Ultrasound Guided Thoracic Paravertebral Nerve Block In Video-assisted Thoracoscopic Surgery

ObjectiveTo observe the clinical effect of ultrasound-guided thoracic paravertebral nerve block?TPVB?in early analgesia in video-assisted thoracoscopic surgery?VATS?.Methods60 patients were scheduled for the first total intravenous anesthesia in video-assisted thoracoscopic surgery,ASA?or?,aged 18 to 70 years,BMI 18 to 29kg/??were enrolled in our study.They were randomly divided into two groups which were 30patients in each group.The first one was preoperative single ultrasound guided TPVB?T group?,the second one was postoperative patient-controlled intravenous analgesia?PCIA?group?P group?.Patients in the preoperative single ultrasound guided TPVB?P group?were given Injection of 0.375%ropivacaine 15ml before TIVA induction.Patients in postoperative patient-controlled intravenous analgesia?PCIA?group?P group?were given postoperative patient-controlled intravenous analgesia after surgery.After video-assisted thoracoscopic surgery,two groups were given sufentanil 1.5?g/kg analgesic pump.Preoperative visits?T₁?,30 min after extubation?T₂?,3 h after extubation?T₃?,6 h after extubation?T₄?,12 h after extubation?T₅?,24 h after extubation?T₆?48h?T₇?heart rate,mean arterial pressure,respiratory rate,pulse oximetry after anesthesia;anesthesia induced dose;anesthesia to maintain micro pump injection;T₂^T₄?T₆^T₇ point of calm breathing and coughing Visual analog score?VAS?,Ramsay sedation score for T₂ time point,Removal of thoracic closed drainage tube after surgery,Postoperative time to discharge,postoperative adverse reactions?nausea,vomiting,chills,respiratory depression,intraoperative hypotension?.Group T recorded related complications caused by TPVB?local anesthetic toxicity,pneumothorax total spinal anesthesia?.ResultsThere were no significant differences among two groups forgeneral conditions,preoperative basal vital signs,anesthetic-induced medicinal dose,intraoperative continuous pumping of dexmedetomidine,VAS scores during quiet breathing and coughing in the T₇ time point?P>0.05?.Compared with the T group,There were significant differences in VAS score,Ramsy score,postoperative time to removal of thoracic closed drainage tube,and postoperative to discharge time during quiet breathing and cough at T₂^T₄?T₆?P<0.05?.There was a statistically significant difference between the two groups in the amount of anesthesia-induced sufentanil and intraoperative pumping of propofol and remifentanil?P<0.05?.Adverse reactions were not statistically significant between the two groups.No TPVB-related complications were found in the T group.ConclusionUltrasound-guided thoracic paravertebral nerve block can reduce the amount of opioids used in patients and effectively reduce the early postoperative pain of video-assisted thoracoscopic surgery,and promote rapid recovery after surgery.