Effect of Preoperative Paravertebral Block Combined with Intravenous Analgesia on Perioperative Analgesia in Patients Undergoing Thoracoscopic Lobectomy
WANG Zhao-jun, SHANG You
The First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121004, Liaoning
Abstract：【Objective】 To investigate the effect of preoperative paravertebral block (TPVB) combined with intravenous analgesia on perioperative analgesia in patients undergoing thoracoscopic lobectomy.【Methods】 From September 2019 to April 2020, 99 patients with elective thoracoscopic lobectomy in our hospital were selected and randomly divided into group A (n=33), group B (n=33) and group C (n=33). The group A was given patient-controlled intravenous analgesia; group B was given single and double-point TPVB before induction; group C was placed with ultrasound-guided paravertebral catheter before induction, and continuous TPVB was used for postoperative analgesia. The VAS and sedation scores at 1 h (T0), 4 h (T1), 24 h (T2) and 48 h (T3) of the three groups were recorded; the dosage of propofol, sevoflurane and sufentanil during the operation was recorded; the times of pressing, the times of pain relief, recovery time, extubation time and adverse reactions were recorded. 【Results】 The VAS score of the group B and the group C was lower than that of the group A at T0, T1, T2 and T3, and that of the group C was lower than that of the group B (all P<0.05). The sedation score of the group B and the group C was higher than that of the group A (P<0.05); there was no significant difference between the group B and the group C (P>0.05). The times of pressing and the times of pain relief in the group B and the group C were lower than those in the group A (P<0.05); there was no significant difference between the group B and the group C (P>0.05). The intraoperative dosage of propofol, sevoflurane and sufentanil in the group B and C was lower than that in the group A (P<0.05), and the recovery time and extubation time in the group B and C were shorter than those in the group A (P<0.05), but there was no significant difference between groups B and C (P>0.05). The incidence of adverse reactions was 30.30% (10 / 33) in the group A, 21.21% (7 / 33) in the group B and 15.15% (5 / 33) in the group C. There was no significant difference among the three groups (P>0.05).【Conclusion】 The effect of continuous TPVB combined with intravenous analgesia by paravertebral catheterization and ultrasound-guided single and double point TPVB in patients undergoing thoracoscopic lobectomy is superior to patient-controlled intravenous analgesia in reducing the dosage of propofol, sevoflurane and sufentanil, but the effect of TPVB combined with intravenous analgesia is better than that of single and double point TPVB, and TPVB combined with intravenous analgesia does not increase the incidence of postoperative adverse reactions.
2020, Vol. 37 
