Influence of ultrasound-guided continuous paravertebral nerve block combined with general anesthesia on stress response of thoracoscopic bullae resection
XU Zhu-hong1 ZOU Min2 WANG Liang-ping1
1.Department of Anesthesiology,Renkang Hospital of Dongguan of Guangdong Province,Dongguan 523952,China;
2.Department of Anesthesiology,People′s Hospital of Guangming New District in Shenzhen City,Guangdong Province,Shenzhen 518106,China
Abstract：ObjectiveTo investigate the influence of ultrasound-guided continuous thoracic paravertebral nerve block combined with general anesthesia on stress response in patients undergoing thoracoscopic resection of bullae.Methods100 patients who underwent unilateral thoracoscopic bullous resection in our hospital from January 2011 to January 2016 were selected as the objects.The patients were divided into the observation group and the control group according to the method of random number table method,50 cases in each group.The observation group was given ultrasoundguided continuous thoracic spinal nerve block combined general anesthesia,the control group was given only general anesthesia.All patients in the two groups underwent controlled intravenous analgesia.The visual analogue scale(VAS)was recorded at 2,6,12,24 h after operation.The blood glucose,epinephrine(E),norepinephrine(NE)and dopamine(DA)concentrations were measured before and during anesthesia and at 24 h after operation.Radioimmunoassay was used for the determination.ResultsThe VAS scores of the observation group after operation at 2,6 and 12 h was significantly lower than that of the control group,with significant difference (P＜0.05).The VAS scores of the observation group after operation at 6,12 and 24 h was significantly lower than that 2 h after operation,and the VAS score of the observation group at 24 h after operation was significantly lower than that 6 and 12 h after operation,with significant difference(P＜0.05).The VAS scores of the control group after operation at 6,12 and 24 h was significantly lower than that after operation at 2 h,the VAS score of the control group at 12 h after operation was significantly lower than that after operation at6 h,and the VAS score after operation at 24 h of the control group was significantly lower than that after operation at 6 and 12 h,with significant difference (P＜0.05).There was significant difference in the levels of E,blood glucose,DA and NE of the two groups between after operation at 24 h and before anesthesia(P＜0.05).There was significant difference in the levels of E,DA and NE of the two groups between after operation and before anesthesia (P＜0.05).There was significant difference in the levels of E,blood glucose,DA and NE of the control group between after operation at 24 h and before anesthesia (P＜0.05).There was significant difference in the levels of E,blood glucose and NE of the observation group between after operation at 24 h and before anesthesia(P＜0.05).There was significant difference in the levels of E,blood glucose,DA and NE after operation at 24 h between the observation group and the control group (P＜0.05).Conclusion Thoracic paravertebral nerve block combined with general anesthesia under ultrasound guidance has little effect on the stress response of patients undergoing thoracoscopic bullae resection,which also reduces the pain and improves the patient comfort.
Steinthorsdottir KJ，Wildgaard L，Hansen D，et al.Regional all algesia for video-assisted thoracic surgery：a systematic review[J].Eur J Cardiothorae Surg，2014，45（6）：959-966.
[2]
Hall Burton DM，Boretsky KR.A comparison of paravertebral nerveblockcathetersandthoracicepiduralcathetersforpostoper-ative analgesia following the Nuss procedure for pectus excavatum repair[J].Paediatr Anaesth，2014，24（5）：516-520.
[3]
Maehino A，Wakamatsu M，Kaida T，et al.Postoperative pain management in video assisted thoracic surgery using a continuous unilateral intercostal analgesia[J].Masui，2014，63（12）：1319-1323.
Young R，McElnay P，Leslie R，et al.Is uniport thoracoscopic surgery less painful than multiple port approaches[J].Interact Cardiovasc Thorac Surg，2015，20（3）：409-411.
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