Ultrasound Guided Paravertebral Nerve Block in Thoracotomy

Abstract

The pain after thoracic surgery is often moderate to severe. Perioperative analgesia has always been one of the research hotspots of thoracic anesthesia. The patients were prepared before operation according to the routine, and the fasting time was performed according to the fasting guidelines before anesthesia for adult surgery. After entering the operating room, first establish an infusion channel in the vein of the upper limb, and routinely use a monitor to monitor the basic vital signs. Puncture the right internal jugular vein and place the tube under ultrasound; Under local anesthesia, the radial artery was punctured and catheterized, and the catheter was connected with the transducer to monitor the invasive blood pressure. All patients in group P used the puncture method through the lateral approach. Use the same method on the opposite side. The plane was measured by acupuncture. If there was hypoesthesia, the effect of block was determined, and the spinal nerve block segments after plane fixation were recorded. The complications related to puncture (such as pneumothorax, hemothorax, local anesthetic poisoning, etc.), operation time, extubation time, propofol, remifentanil and the use of cisatracurium during maintenance were recorded. Among all patients, the patients with ID ≥ 2 in TPVB group and Gen group were 14.1% and 18.8% respectively, and the difference was not statistically significant (P > 0.05). Thoracic paravertebral block combined with general anesthesia is beneficial to reduce perioperative complications, incidence rate and mortality, and improve postoperative outcome.