Clinical Investigation of Ultrasound-guided Thoracic Paravertebral Nerve Block for Patients Following Video-Assisted Thoracic Surgery Lobectomy
LIU Jia-peng,ZHUO Na,HAN Jian-ge
Department of Anesthesiology,Tianjin Cardiovascular Diseases Institute, Tianjin Chest Hospital,Tianjin300352,China
Abstract:
Objective To compare the analgesic effect and the incidence of complications between TPVB and TEA in Video-assisted Thoracic Surgery (VATS). Methods 52 patients undergoing VATS lobectomy were randomly divided into two groups: thoracic epidural group(group E, n =26)and ultrasound-guidedthoracic paravertebral nerve block group (group P, n =26).Intraoperative fluid consumption, sufentanilcumulative consumption and vasopressor consumption were recorded. The Visual Analog Scale (VAS) score at deep breath and rest, Ramsey Sedation Scale(RSS), Post Operative Nausea And Vomiting (PONV)times, side effects and overall patient satisfaction were measured at the time points of 6 h(T1), 12 h(T2), 24 h(T3), 36 h(T4), 48h(T5) and 72 h(T6)after surgery during three days' follow-up. Results There was no difference in sufentanil cumulativedosage and liquid dosage between the two groups during operation, but the durationand the using of vasoactive drugs in group E were more than those in group P. There were significant differences in dynamic VAS score between the two groups at T1 and T2 time points after operation.There was no statistically significant difference between two groups in the VAS score in all time points. There was significant differences (P =0.023) towards the level of sedation between the two groups from 6 h to 12 h postoperatively, which Group P has deeper RSS scores than group E in all time points. However the incidence of dizziness is significantly high in group P. Conclusion Preemptive ultrasound-guidedthoracic paravertebral block combining with PCIA can provide comparable analgesia to thoracic epidural analgesia without significant adverse effects.
