Abstract：
Background: For children with congenital lung malformations (CLMs), there is insufficient evidence of the efficacy of direct visual paravertebral block (PVB). We aimed to evaluate its effectiveness and safety by comparing it with local anesthetic infiltration (LAI). Materials and Methods: This was a nonrandomized control study of CLMs in children younger than 3 years of age who underwent thoracoscopic surgery in our hospital from January to December 2020. The children were divided into group A (PVB analgesia group) and group B (LAI group). The primary outcome was the incidence of rebound pain within 72 hours. Secondary outcomes included the Face, Legs, Activity, Crying, Consolability (FLACC) pain scores at 0, 6, 12, 24, 36, 48, and 72 hours, side effects, adverse events, the number of rebound pains, and the postoperative family observation scores. Results: The incidence of rebound pain was 10% in group A and 60.5% in group B within 72 hours (P < .001). The PVB was associated with decreased FLACC pain scores at 12, 24, 36, 48, and 72 hours, family observation scores, and the number of rebound pains (P < .001, P = .01, P = .028, P = .005, P = .006, P = .026, and P < .001, respectively). Group B was also associated with a higher rate of side effects and adverse events. There was no difference in the length of hospital stay. Conclusion: The PVB under direct vision analgesia technique is effective and safe for postoperative pain control in pediatric patients with CLMs. It may be an attractive alternative to LAI for pediatric thoracoscopic surgical procedures.
摘要：
背景：对于患有先天性肺畸形（CLM）的儿童，直接视觉椎旁阻滞(PVB)疗效的证据不足.我们旨在通过将其与局部麻醉浸润（LAI）进行比较来评估其有效性和安全性。材料与方法：这是一项非随机对照研究，对2020年1月至12月在我院接受胸腔镜手术的3岁以下儿童的CLMs进行研究。将患儿分为A组(PVB镇痛组)和B组(LAI组)。主要结果是72小时内反弹疼痛的发生率。次要结果包括面部，腿,活动,哭泣,在0、6、12、24、36、48和72小时时，可协性（FLACC）疼痛评分，副作用,不良事件,反弹疼痛的次数，术后家庭观察评分。结果:72h内反弹痛发生率A组为10%,B组为60.5%(P<.001)。PVB与12、24、36、48和72小时的FLACC疼痛评分降低相关，家庭观察评分,和反弹疼痛次数（分别为P<.001，P=.01，P=.028，P=.005，P=.006，P=.026和P<.001）。B组的副作用和不良事件发生率也较高。住院时间没有差异。结论：直视下PVB镇痛技术对小儿CLM患者术后疼痛控制有效，安全。它可能是小儿胸腔镜手术中LAI的有吸引力的替代方案。
