Ultrasound-guided thoracic paravertebral nerve block combined with propofol general anesthesia for lung cancer surgery and evaluation of acute and chronic post-surgical pain(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2023年第5期
- Page:
- 637-
- Research Field:
- 医学生物物理
- Publishing date:
Info
- Title:
- Ultrasound-guided thoracic paravertebral nerve block combined with propofol general anesthesia for lung cancer surgery and evaluation of acute and chronic post-surgical pain
- Author(s):
- DAI Changzong; YI Zhiguo; DENG Jiandong
- Department of Anesthesiology, the First Hospital of Changsha City, Changsha 410005, China
- Keywords:
- lung cancer propofol parathoracic nerve block analgesia pain
- PACS:
- R614
- DOI:
- DOI:10.3969/j.issn.1005-202X.2023.05.018
- Abstract:
- objective To explore the effect of ultrasound-guided thoracic paravertebral nerve block combined with propofol general anesthesia on lung cancer surgery and to evaluate the acute and chronic post-surgical pain. Methods A total of 102 patients with lung cancer were enrolled and randomly divided into observation group and control group, with 51 cases in each group. Control group was given sevoflurane inhalation combined with intravenous medication for general anesthesia, while observation group was treated with thoracic parathoracic nerve block-propofol intravenous general anesthesia. The systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) at different perioperative time points, the dosage of opioid drug used during surgery, the post-surgical visual analogue score (VAS) at different time points in a calm state and active coughing state, and the total dosage and pressing frequency of PCA within 48 h were compared between two groups. All patients were followed-up for assessing the chronic pain after discharge Results There was no statistically significant difference in SBP, DBP and HR at T0 between two groups (P>0.05). The SBP and DBP in two groups at T1 and T2 were significantly decreased as compared with those at T0 (P<0.05), and the indexes in control group were significantly higher than those in observation group (P<0.05). The HR in two groups at T1 was close to that at T0 (P>0.05), but the HR at T2 was significantly decreased compared with that at T0 (P<0.05), and the HR in control group was significantly higher than that in observation group (P<0.05), and the HR in control group at T2 was significantly decreased compared with that at T1 (P<0.05). More opioid drug was used in control group than in observation group (P<0.05). Within 48 h after surgery, the frequency of analgesic pump pressing in observation group was significantly less than that in control group (P<0.05). At extubation and 2 h and 24 h after surgery, the VAS in observation group in a clam state and active coughing state were significantly lower than those in control group (P<0.05). The VAS in observation group at 24 h after surgery in a clam state and active coughing state were significantly increased compared with those at 2 h after surgery (P<0.05), while in control group, the VAS in a clam state was significantly higher than that at 2 h after surgery (P<0.05), and the difference in the score at active coughing state between 24 h and 2 h after surgery was trivial (P>0.05). The follow-up showed that observation group had a lower incidence of chronic pain than control group (P<0.05). Conclusion Thoracic paravertebral nerve block-propofol general anesthesia can effectively reduce the pain after lung cancer surgery, and it is beneficial to the hemodynamics during surgery, the reduction of the dosage of anesthetic drug, the relief of postoperative pain, and the postoperative rehabilitation of patients with lung cancer.
Last Update: 2023-05-26