Comparative Observation on Analgesic Effect and Safety of Different Modes of Nerve Block Combined with General Anaesthesia After VATS in Elderly Patients
Objective To observe the differences in analgesic effects and safety of different modes of nerve block combined with general anaesthesia after television-assisted thoracoscopy ( VATS ) in the elderly.Methods Eighty patients who underwent VATS lobectomy under general anaesthesia in the elective thoracic surgery department of our hospital were divided into three groups.27 patients in group T underwent thoracic paravertebral nerve block ( TPVB ),26 patients in group E underwent erector spinae plane block ( ESPB ),and 27 patients in group Ⅰ underwent intercostal nerve block ( ICNB ),with the use of intravenous controlled analgesia ( PCIA ) at the end of the operation.The clinical effects and safety of the three groups were compared.Results The time to first postoperative analgesic pump pressure was longer in Groups E and T than in Group Ⅰ,and the number of effective analgesic pump presses was less than in Group Ⅰ in the 48h postoperative period ( P<0.05 ) .The visual analogue scale ( VAS ) scores at rest and cough were higher in all three groups at 4,8,12,and 24h postoperatively than at 2h postoperatively ( P<0.05 ) .The VAS scores at rest at 8,12,and 24h postoperatively,and the VAS scores at cough at 4,8,12,and 24h postoperatively in groups E and T were lower than those in group Ⅰ ( P<0.05 ) .Inflammatory factors were higher in all three groups at 12 and 24h postoperatively than preoperatively ( P<0.05 ) .Postoperative inflammatory factors were lower in groups E and T than in group Ⅰ ( P<0.05 ) .Postoperative inflammatory factors were lower in group T than in group E ( P<0.05 ) .Conclusion TPVB and ESPB provide similar analgesic effects in elderly patients after VATS,with TPVB exhibiting a stronger inhibitory effect on the body's inflammatory response,without increasing adverse reactions.
Erector Spinae Plane BlockIntercostal Nerve BlockThoracic Paravertebral Nerve BlockThoracic SurgeryVideo-Assisted Thoracoscopic Surgery ( VATS )AnalgesiaSafetyEfficacy Comparison Study
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维普
