CHENG Yongchong 1 , ZHU Jian 2 , MA Guangbing 1 , SONG Xiaoyang 3 , LI Bixi 3 , LI Kun 3 , WEN Wei 4
  • 1. Department of Anesthesiology, The 987th Hospital of Joint Logistics Support Force of People's Liberation Army, Baoji, 721004, Shannxi,P. R. China;
  • 2. Department of Thoracic Cardiovascular Surgery, General Hospital of Central Theater Command of the People's Liberation Army, Wuhan, 430070, P. R. China;
  • 3. Department of Anesthesiology, General Hospital of Central Theater Command of the People's Liberation Army, Wuhan, 430070, P. R. China;
  • 4. Department of Thoracic Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, P. R. China;
LI Kun, Email: zbzqzyylk@126.com; WEN Wei, Email: wenwei@jsph.org.cn
Thoracic paravertebral block; lung cancer; lobectomy; thoracoscopy; enhanced recovery after surgery
10.7507/1007-4848.202410042
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Objective To explore the safety and efficacy of thoracoscopic guided thoracic paravertebral block (TPVB) in resection of lung, and to provide strategies for enhanced recovery after surgery of lung surgery. Methods A total of 180 patients with thoracoscopic surgery of lung (including sublobar resection and lobectomy) hospitalized between May 2021 and June 2023 were included. There were 108 females and 72 males with an average age of (62.15±7.36) years. Patients were divided into 3 groups. Patients received subcutaneous injection of ropivacaine (concentration: 0.375%, dose: 2 mg/kg) on peripheral incision at chest closing were allocated into a group A. Patients received ultrasound-guided injection of ropivacaine (concentration: 0.375%, dose: 2 mg/kg) at the TPVB point after chest closing into a group B. Patients received thoracoscopic guided injection of ropivacaine (concentration: 0.375%, dose: 2 mg/kg) before chest closing at the TPVB point into a group C. The baseline data of each group were compared, and the effectiveness outcomes included perioperative adverse drug reactions, pain scores, postoperative analgesic drug use and postoperative hospital stay were compared among the 3 groups. Results There were no statistical differences in the baseline data of three groups, including age, weight, gender, incidence of previous underlying diseases, operation time, number of surgical incisions, number of drainage tubes inserted, and dosage of sufentanil or propofol used during surgery (P>0.05). There were no adverse anesthesia events in the 3 groups during the operation, the frequency of self-controlled intravenous analgesia pump, the VAS score, the incidence of adverse reactions, and the rate of postoperative analgesic drug use in group C was less or lower than the other two groups (P<0.05). The hospital stay in the group C and group B were lower than that in the group A (P<0.05). Conclusion Thoracoscopic guided TPVB can reduce postoperative pain without increasing postoperative side effects, which had accelerated the enhanced recovery after surgery of lung.

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