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| Influence of general anesthesia combined with ultrasound-guided thoracic paravertebral block on postoperative pain and stress response in patients with thoracotomy |
| ZHANG Jian-hua LU Xian-qing HE Hui-jiao PAN Yan-tao |
| Department of Anesthesiology,the First People′s Hospital of Zhaoqing City in Guangdong Province,Zhaoqing 526060,China |
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Abstract ObjectiveTo investigate the influence of thoracic paravertebral block (TPVB)on postoperative pain and stress response in patients undergoing thoracotomy under general anesthesia combined with ultrasound.MethodsFrom March 2015 to October 2016,48 esophageal cancer patients undergoing thoracotomy in selective period were selected and randomly divided into the simple general anesthesia group(the control group)and the general anesthesia combined with TPVB group (the observation group),24 cases in each group.The general anesthesia applied in the two groups was the same.In the observation group,the ultrasound-guided TPVB was performed before induction of general anesthesia.The intravenous patient-controlled analgesia after surgery was used.The hemodynamics were recorded before anesthesia(T1),immediately after endotracheal intubation(T2),30 min after operation(T3),just after surgery(T4),2 h after surgery(T5),and visual analogue scale(VAS)and Ramsay scores at T5,4 h after operation(T6),8 h after operation(T7),24 h after operation (T8),and 48 h after operation (T9)were also recored.The levels of norepinephrine (NE),epinephrine(E),and dopamine(DA)at T1,T3,T4,T8were detected.The number of postoperative analgesia pump press,sufentanil dose,analgesic satisfaction,and relevant complications were also recorded.ResultsCompared with the control group,systolic blood pressure(SBP),diastolic blood pressure(DBP),and heart rate(HR)at T2,T3and T4were all higher in the observation group(P＜0.05).The VAS scores at T5,T6,T7,T8and T9in both quietness and activity were lower in the observation group (P＜0.05).There was no difference in Ramsay sedation score between the two groups(P＞0.05).The levels of NE and E were higher in the observation group at T3and T4(P＜0.05)and decreased at T5(P＜0.05).The levels of DA was lower at T4and T5(P＜0.05).The number of analgesia pump press was less(P＜0.01).The sufentanil dose was less at 0-12 h and ＞12-24 h(P＜0.01).The analgesic satisfaction was higher (P＜0.05).ConclusionGeneral anesthesia combined with ultrasoundguided TPVB can provide effective analgesia for thoracotomy,greatly inhibit stress response,and reduce the dose of postoperative analgesic drugs.
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| Cite this article: |
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ZHANG Jian-hua LU Xian-qing HE Hui-jiao PAN Yan-tao. Influence of general anesthesia combined with ultrasound-guided thoracic paravertebral block on postoperative pain and stress response in patients with thoracotomy[J]. 中国当代医药, 2018, 25(6): 12-16.
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| URL: |
| http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2018/V25/I6/12 |
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