Comparison of the efficacy of ultrasound-guided paravertebral nerve block and modified serratus anterior plane block in thoracoscopic lobectomy in elderly patients with non-small cell lung cancer
ZUO Ming-ming
YANG Jing
LU Min
SUN Jing-jing
ZHANG Lin
Abstract：Objective To compare the efficacy of ultrasound-guided paravertebral nerve block(PVB)and modified serratus anterior plane block(SAPB)in thoracoscopic lobectomy in elderly patients with non-small cell lung cancer.Methods A total of 86 elderly patients with non-small cell lung cancer who underwent elective thoracoscopic lobectomy in Cangzhou People's Hospital from July 2022 to September 2024 were selected,including 56 males and 30 females,aged(66.42±4.45)years old,the age ranging from 61 to 76 years old.Patients were divided into PVB group(n=43)and modified SAPB group(n=43)by random number table method.The PVB group was treated with general anesthesia combined with ultrasound-guided PVB,and the modified SAPB group was treated with general anesthesia combined with ultrasound-guided modified SAPB.The operation time,intraoperative blood loss,anesthesia time,pain visual analogue scale(VAS)scores in active and resting states at each time point after extubation[10 min(T0),2 h(T1),6 h(T2),12 h(T3),24 h(T4),48 h(T5)after extubation],perioperative hemodynamic parameters[mean arterial pressure(MAP)and heart rate before anesthesia induction,5 min after intubation,5 min after skin incision,30 min after skin incision,and end of operation],postoperative analgesia[number of patient controlled intravenous analgesia(PCIA)pressing,24 h analgesic rescue rate,24 h postoperative sufentanil consumption,48 h postoperative sufentanil consumption]and adverse reactions were recorded and compared between the two groups.Results There was no significant difference in operation time,intraoperative blood loss,anesthesia time,and MAP,heart rate at each time point between the two groups(P＞0.05).The pain VAS scores in active states of modified SAPB group at T1and T4 were lower than those of PVB group with statistically significant(P＜0.05).There was no significant difference in pain VAS scores in active states at T0,T2,T3 and T5 and in resting states at each time point between the two groups(P＞0.05).There was no significant difference in the number of PCIA pressing,24 h analgesic rescue rate,24 h postoperative sufentanil consumption between the two groups(P＞0.05).The 48 h postoperative sufentanil consumption in the modified SAPB group was lower than that in the PVB group at 48 h with statistically significant(P＜0.05).The incidence of adverse reactions was 11.6％(5/43)in PVB Group and 9.3％(4/43)in modified SAPB group,there was no significant difference between the two groups(P＞0.05).Conclusion The analgesic effect of ultrasound-guided PVB and modified SAPB in thoracoscopic lobectomy in elderly patients with non-small cell lung cancer is similar,with less influence on intraoperative hemodynamics,while modified SAPB can effectively reduce the dosage of sufentanil after the operation and provide better analgesic effect.
Keywords：Paravertebral nerve blockSerratus anterior plane blockNon-small cell lung cancerThoracoscopic lobectomyElderly
Publication Date：2025-07-25
Online Publishing Date：2025-08-26(First online date of this platform, not the publication date of the document)
Pages：6( 278-283 )