The effect of ultrasound-guided paravertebral nerve block combined with intrathoracic vagus nerve block on rapid recovery after thoracoscopic surgery

Qiu Rongen; Lan Yunping; Li Jin; Zhang Yanqing; Zeng Ruifeng

doi:10.3760/j.issn.1673-4777.2024.09.018

Abstract：Objective To investigate the effect of ultrasound-guided paravertebral nerve block(TPVB)combined with intrathoracic vagus nerve block on rapid recovery after thoracoscopic surgery.Methods A total of 66 patients with lung cancer who underwent thoracoscopic surgery in Quzhou City People's Hospital from February 2022 to January 2023 were selected as the research objects,and they were divided into the control group and the observation group by random number table method,with 33 cases in each group.Both groups received video-assisted thoracoscopic surgery for lung cancer.The control group was given general anesthesia with double-lumen bronchial intubation,and the observation group was given non-intubation intravenous anesthesia with ultrasound-guided TPVB combined with intrathoracic vagus nerve block.The postoperative recovery,mean arterial pressure,heart rate,degree of pain and incidence of postoperative complications were observed between the two groups.Results The first feeding time and hospital stay of the observation group were shorter than those of the control group,and the partial pressure of carbon dioxide in arterial blood 30 min after the operation was higher than that of the control group(all P＜0.001).The heart rate and mean arterial pressure in the control group were higher than those before anesthesia induction 30 min after operation and immediately after operation(both P＜0.05);but there were no significant differences in heart rate and mean arterial pressure before and after anesthesia induction in the obser-vation group(all P＞0.05);and the heart rate and mean arterial pressure in the observation group were lower than those in the control group[heart rate:(75±8)times/min vs(81±7)times/min,(76±8)times/min vs(83±10)times/min;mean arterial pressure:(81±9)mmHg vs(90±9)mmHg,(82±8)mmHg vs(93±10)mmHg](all P＜0.05).There was no significant difference in visual analogue scale score between the two groups at 30 min before operation(P＞0.05).At 1,6,12,24 and 48 h after operation,the visual analogue scale scores of the observation group were lower than those of the control group(all P＜0.05).The incidence of complications in the observation group was lower than that in the control group[6.1％(2/33)vs 15.2％(5/33)](x2=4.243,P=0.039).Conclusion Compared with the double-lumen endotracheal intubation general anesthesia method,for patients undergoing video-assisted thoracoscopic surgery,ultrasound-guided TPVB combined with intrapleural vagus nerve block can avoid fluctuations in blood pressure and heart rate,reduce postoperative pain,accelerate postoperative recovery,and reduce the incidence of postoperative complications.