Comparison of the effects of ultrasound-guided intertransverse process block and paravertebral nerve block on perioperative analgesia in two-port video-assisted thoracoscopic surgery
ZHOU Xinyue
DU Haiyun
CHEN Qian
QIAN Bin
Abstract：Objective To compare the analgesic effects of ultrasound-guided intertransverse process block(ITPB)and paravertebral nerve block(PVB)on perioperative analgesia in two-port video-assisted thoracoscopic surgery.Methods Seventy patients who underwent elective two-port thoracoscopic partial lung resection in Yancheng No.1 Peoples Hospital from November 2022 to June 2023 were recruited and divided into observation group and control group by random number table method,with 35 cases in each group.After excluding cases,34 cases were ultimately included in each group for analysis.The observation group underwent ITPB and the control group underwent PVB.Changes in values of heart rate and mean arterial pressure before and after skin incision,intraoperative analgesic consumption,Visual Analogue Scale(VAS)scores for resting state and active state 30 minutes(T1),4 hours(T2),8 hours(T3),16 hours(T4)and 24 hours(T5)after extubation,morphine equivalent consumption,the number of analgesic pump compressions and the times of remedial analgesia 24 hours after surgery,and the occurrence of adverse reactions were compared between the two groups.Results The nerve block time in the observation group was shorter than that in the control group,and the difference was statistically significant(P＜0.05).There were no significant differences in the changes in values of heart rate and mean arterial pressure before and after skin incision,and intraoperative dosage of fentanyl and dosage of remifen-tanil between the two groups(P＞0.05).There were no significant differences in the morphine equivalent consumption,the number of analgesic pump compressions and the times of remedial analgesia 24 hours after surgery between the two groups(P＞0.05).The postoperative VAS scores for resting state and active state in the two groups increased as time progressed,but there were no significant differences in the VAS scores between the two groups at each time point(P＞0.05).The incidence rate of hematoma after puncture in the observation group was significantly lower than that in the control group(P＜0.05),and there were no significant differences in the incidence rates of intraoperative hypotension and postoperative nausea and vomiting between the two groups(P＞0.05).Conclusion The analgesic effect of ultrasound-guided ITPB during the perioperative period in two-port video-assisted thoracoscopic surgery is comparable to that of PVB,and the risk of hematoma after puncture in ultrasound-guided ITPB is lower and the safety is better.Ultrasound-guided ITPB can be used as an alternative therapy for PVB.
Keywords：Intertransverse process block(ITPB)Paravertebral nerve block(PVB)Two-port video-assisted thoracoscopic surgeryPerioperative analgesia
Publication Date：2024-07-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 794-799 )