Effects of ultrasound-guided thoracic paravertebral nerve block on postoperative analgesia in patients with rib fracture

ZHANG Ying; CHEN Jun; WANG Ai-zhong; LI Qian-ping; CHENG Shao-fei

doi:10.3969/j.issn.1009-4237.2016.10.005

Abstract：Objective To observe the effects of ultrasound-guided thoracic paravertebral nerve block on postoperative analgesia in patients with rib fracture .Methods Forty patients scheduled for rib fracture internal fix-ation under general anesthesia were randomly divided into two groups ( n =20 each ): general anesthesia group (group GA) and general anesthesia combined with thoracic paravertebral nerve block group (group GA+TPVB). After induction of anesthesia ,ultrasound-guided thoracic paravertebral nerve block was performed and 0.5%Ropiva-caine was injected in group GA +TPVB,while nothing was done in group GA .All patients received intravenous an-algesia with sufentanil in the PACU .Dynastat 40 mg was injected at two times a day in the first three days after sur-gery.The hemodynamic parameters during skin incision were recorded .The consumption of sufentanil during opera-tion and VAS score at 1,6,12,24 and 48h after operation were recorded .The adverse reactions were also recorded . Results Compared with group GA ,hemodynamic parameters in group GA +TPVB maintained even stable during skin incision(P<0.05);sufentanil consumption was significantly reduced during operation (P<0.05);VAS at 1, 6,12,24 and 48h after operation were significantly lower (P<0.05).The postoperative vomitting rate in group GA and group GA+TPVB was 15%and 0, respectively.There was no adverse reaction in either groups .Conclusion Ultrasound-guided thoracic paravertebral nerve block can provide accurate positioning ,high operation success rate , and effective analgesia .And it can obviously decrease the need for analgesic drugs in perioperative period .