| Objectives To evaluate the effect of lateral erector spinal plane block on delirium after thoracoscopic lobectomy in elderly patients.Methods A clinical randomized controlled trial design was adopted.According to the inclusion criteria and exclusion criteria,100 elderly patients who were admitted to our hospital for thoracoscopic lobotomy from January 2020 to January 2021 were collected.Using two groups of independent sample design,the patients were randomly divided into two groups with 50 patients in each group according to the computer random number method,the patients were divided into two groups randomly according to the computer random number method,the patients were randomly divided into two groups: the experimental group and the control group.Patients were divided into two groups.The experimental group(EP group)was treated with single ESP block combined with PCIA,control group(P)was treated with PCIA alone.The score of follow-up was carried out by special researchers,and the way of anesthesia was single-blind to the follow-up staff.The primary outcome measures were the period of awakening and the incidence of delirium events within 1 to 5 days postoperatively.Secondary observing indexes including operation time,anesthetic drugs(intraoperative propofol and sufentanil,the dose of fentanyl),anesthesia recovery(withdrawal-recovery time of spontaneous breathing,withdrawal,open time and drug withdrawal,extubation time)changes,pain(24h dizocin consumption and ward recovery),adverse reactions,such as nausea,vomiting,dizziness,atelectasis,urinary retention,etc.)and prognosis(postoperative hospital stay).SPSS25.0 software was used to process the data,and P<0.05 was considered statistically significant.Results 1 Among the patients finally included in the study,47 were male,accounting for 47.0%;A total of 53 cases were female,accounting for 53.0%.The youngest was 65 years old,the largest was 75 years old,and the average age was 69.49±3.22 years old.The results showed that the majority of patients(11 cases,12.0%)developed POD during the wake period,and the incidence of POD in the P group was higher than that in the EP group,with statistical significance(P=0.025).2.There was no significant difference in operation time,anesthetic drugs and anesthesia recovery between the two groups(P>0.05).In terms of the amount of anesthetic drugs,there was a significant positive linear correlation between the amount of intraoperative remifentanil,sufentanil and propofol(P<0.05).In terms of anesthetic dosage,the study results showed that the intraoperative amounts of remifentanil,sufentanil and propofol in P group were significantly higher than those in EP group,and the difference was statistically significant(P<0.001).In terms of anesthesia recovery,the study results showed that the time from drug discontinuation to spontaneous breathing,from drug discontinuation to eye opening,and from drug discontinuation to extubation in group P were all longer than those in group EP,and the differences were statistically significant.3.In terms of postoperative pain and adverse reactions,the 24 h consumption of desocine in patients using PCIA alone was significantly higher than that of ESP block combined with PCIA.There was no significant difference between the two types of anesthesia on other anestheties-related adverse reactions(such as the frequency of intraoperative hypotension,nausea and vomiting,urinary retention,atelectasis,etc.)(P>0.05).4.In terms of prognosis,patients treated with PCIA alone had significantly longer hospital stays than those treated with ESP block combined with PCIA.Conclusions The application of erector spinal plane block in elderly patients undergoing thoracoscopic lobectomy can reduce the dosage of general anesthesia,shorten the length of hospital stay,reduce the incidence of postoperative delirium and improve the prognosis.Figure 3;Table 5;Reference 125... |
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