Comparison of analgesic effects of ultrasound-guided thoracic paravertebral block, erector spinae muscle block, thoracic paravertebral block combined with erector spinae muscle block, and intercostal nerve block in thoracoscopic surgery
120 patients undergoing elective thoracoscopic surgery were randomly divided into ESPB group (E group, n=30), TPVB group (T group, n=30), ESPB combine with TPVB group (ET group, n=30), ICNB group (I group, n=30). Patients in ESPB group underwent erector spinal block under ultrasound after anesthesia induction; Patients in TPVB group received thoracic paravertebral nerve block after anesthesia induction; Patients in ESPB group combined with TPVB group received thoracic paravertebral nerve block combined with erectoralis muscle block after anesthesia induction; Patients in INB group received intraoperative intercostal nerve block by the operator. All groups of patients received postoperative controlled intravenous analgesia (PCIA). Visual analogue scale (VAS) was used to evaluate the degree of pain 1h (T1), 24h (T2) and 48h (T3) after surgery. The mean arterial pressure (MAP), heart rate at T1-T3 were recorded, as well as the number of effective analgesic pump compression, the amount of sufentanil and the number of relief analgesia within 48h after surgery. The occurrence of postoperative adverse reactions such as nausea, vomiting, dizziness, retention time of thoracic drainage tube, postoperative hospital stay and postoperative pulmonary complications (pneumonia, atelectasis, pleural effusion, respiratory failure, etc.) were recorded.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
120
Patients undergoing thoracoscopic surgery underwent general anesthesia and patients in TPVB Group received thoracic paravertebral nerve block with 0.33% ropivacaine 30ml under ultrasound guidance after anesthesia induction for postoperative analgesia.
Patients undergoing thoracoscopic surgery underwent general anesthesia and patients in ESPB Group received erector spinae muscle block with 0.33% ropivacaine 30ml under ultrasound guidance after anesthesia induction for postoperative analgesia.
Patients undergoing thoracoscopic surgery underwent general anesthesia and patients in TPVB combined ESPB group received thoracic paravertebral block combined with erector spinae muscle block with 0.33% ropivacaine 30ml under ultrasound guidance after anesthesia induction for postoperative analgesia.
First hospital of Qinhuangdao
Qinhuangdao, Hebei, China
RECRUITINGPostoperative pain score
Visual analogue scale (VAS) was used to evaluate the degree of pain 1h (T1), 24h (T2) and 48h (T3) after surgery, the number of effective analgesic pump compressions and the number of remedial analgesia within 48h after surgery.
Time frame: 48 hours after surgery
Incidence of postoperative complications
Mean arterial pressure (MAP), heart rate, postoperative nausea, vomiting, dizziness and other adverse reactions at T1-T3, retention time of thoracic drainage tube, and postoperative pulmonary complications (pneumonia, atractasis, pleural effusion, respiratory failure, etc.)
Time frame: 48 hours after surgery
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Patients undergoing thoracoscopic surgery underwent general anesthesia and patients in ICNB Group received intercostal nerve block for postoperative analgesia.