Abstract：
BACKGROUND: Ultrasound-guided needle placement has revolutionized the thoracic paravertebral block technique and can be applied in thoracoscopic surgery.
OBJECTIVE: This study investigated the median effective volume (EV50) of an ultrasound-guided single shot of 0.3% ropivacaine used as a thoracic paravertebral nerve block for the radical thoracoscopic resection of lung cancer.
METHODS: A total of 27 patients who received a single shot of ultrasound-guided thoracic paravertebral nerve block and underwent radical thoracoscopic resection of lung cancer were enrolled in this study between February 10 and August 13, 2018. All patients were rated as ASA grades I or II. Using ultrasound as a guide, the block needle was gradually pushed through the lateral costotransverse ligaments to the thoracic paravertebral space by the in-plane technique. After confirming the absence of blood or cerebrospinal fluid, 1-2 ml of 0.3% ropivacaine hydrochloride was injected to confirm that the position of the needle was appropriate, and a pre-determined volume of 0.3% ropivacaine hydrochloride was then administered to the patients. Sensory testing by pinprick was performed every 5 minutes for 30 minutes following the thoracic paravertebral block injection to identify the time segments during which the loss of sensation to the pinprick and its blocking effect occurred.
RESULTS: All patients completed the study and 14 (51.8%) had a successful block.
CONCLUSIONS: The EV50 of 0.3% ropivacaine was 18.46 ml (95% CI 17.09-19.95 ml) and the EV95 was 20.89 ml.
OBJECTIVE: This study investigated the median effective volume (EV50) of an ultrasound-guided single shot of 0.3% ropivacaine used as a thoracic paravertebral nerve block for the radical thoracoscopic resection of lung cancer.
METHODS: A total of 27 patients who received a single shot of ultrasound-guided thoracic paravertebral nerve block and underwent radical thoracoscopic resection of lung cancer were enrolled in this study between February 10 and August 13, 2018. All patients were rated as ASA grades I or II. Using ultrasound as a guide, the block needle was gradually pushed through the lateral costotransverse ligaments to the thoracic paravertebral space by the in-plane technique. After confirming the absence of blood or cerebrospinal fluid, 1-2 ml of 0.3% ropivacaine hydrochloride was injected to confirm that the position of the needle was appropriate, and a pre-determined volume of 0.3% ropivacaine hydrochloride was then administered to the patients. Sensory testing by pinprick was performed every 5 minutes for 30 minutes following the thoracic paravertebral block injection to identify the time segments during which the loss of sensation to the pinprick and its blocking effect occurred.
RESULTS: All patients completed the study and 14 (51.8%) had a successful block.
CONCLUSIONS: The EV50 of 0.3% ropivacaine was 18.46 ml (95% CI 17.09-19.95 ml) and the EV95 was 20.89 ml.
摘要：
背景：超声引导下的针头放置彻底改变了胸椎旁阻滞技术，可应用于胸腔镜手术。
目的：本研究调查了超声引导单次注射0.3%罗哌卡因作为胸椎旁神经阻滞用于肺癌胸腔镜根治术的中位有效体积（EV50）。
方法：2018年2月10日至8月13日，共纳入27例接受超声引导下胸椎旁神经单次阻滞并接受胸腔镜肺癌根治术的患者。所有患者均被评为ASA等级I或II。使用超声波作为指导，通过平面内技术，将阻滞针逐渐穿过肋横断韧带到达胸椎旁间隙。在确认没有血液或脑脊液后，注射0.3％盐酸罗哌卡因1-2毫升，以确认针头位置合适，然后给患者服用预定体积的0.3%盐酸罗哌卡因。胸椎旁阻滞注射后每5分钟进行一次针刺的感觉测试，持续30分钟，以确定发生针刺感觉丧失及其阻滞作用的时间段。
结果：所有患者均完成研究，14例（51.8%）阻断成功。
结论：0.3%罗哌卡因的EV50为18.46ml（95%CI17.09-19.95ml），EV95为20.89ml。
目的：本研究调查了超声引导单次注射0.3%罗哌卡因作为胸椎旁神经阻滞用于肺癌胸腔镜根治术的中位有效体积（EV50）。
方法：2018年2月10日至8月13日，共纳入27例接受超声引导下胸椎旁神经单次阻滞并接受胸腔镜肺癌根治术的患者。所有患者均被评为ASA等级I或II。使用超声波作为指导，通过平面内技术，将阻滞针逐渐穿过肋横断韧带到达胸椎旁间隙。在确认没有血液或脑脊液后，注射0.3％盐酸罗哌卡因1-2毫升，以确认针头位置合适，然后给患者服用预定体积的0.3%盐酸罗哌卡因。胸椎旁阻滞注射后每5分钟进行一次针刺的感觉测试，持续30分钟，以确定发生针刺感觉丧失及其阻滞作用的时间段。
结果：所有患者均完成研究，14例（51.8%）阻断成功。
结论：0.3%罗哌卡因的EV50为18.46ml（95%CI17.09-19.95ml），EV95为20.89ml。
