Abstract：
OBJECTIVE: The purpose of this study was to compare the effect of ultrasound-guided continuous erector spinae plane block to continuous thoracic paravertebral block on postoperative analgesia in elderly patients who underwent thoracoscopic lobectomy.
METHODS: Randomized controlled trial.
METHODS: Elderly patients (N = 50) who underwent nonemergent thoracoscopic lobectomy in the thoracic surgery department of our hospital from January 2019 to December 2020 were selected and randomly divided into continuous erector spinae block (ESPB; n = 25) group and continuous thoracic paravertebral block (TPVB; n = 25) group. The patients in the two groups were guided by ultrasound with ESPB or TPVB before anesthesia induction. The visual analog scale at rest and cough in 2 hours, 6 hours, 8 hours, 12 hours, 24 hours, 48 hours after surgery, the supplementary analgesic dosage of tramadol, time of tube placement, the stay time in postanesthesia care unit (PACU), the first ambulation time after surgery, the length of postoperative hospital stay and postoperative complications were recorded.
RESULTS: There were no significant differences between the two groups in visual analog scale score at rest and cough at each time point and supplementary analgesic dosage of tramadol within 48 hours after surgery (P > .05). The time of tube placement and the postoperative hospital stay in ESPB group was significantly shorter than that in TPVB group (P < .05). There were no differences in PACU residence time and first ambulation time between the two groups (P > .05). There were 4 patients in TPVB group and 2 patients in ESPB group who had nausea and vomiting (P > .05), 1 case of pneumothorax and 1 case of fever in the TPVB group. There were no incision infections or respiratory depression requiring clinical intervention in either group.
CONCLUSIONS: Both ESPB and TPVB alleviated the patients postoperative pain effectively for elderly patients underwent thoracoscopic lobectomy. Compared with TPVB, patients with ESPB have a shorter tube placement time, fewer complications and faster postoperative recovery.
METHODS: Randomized controlled trial.
METHODS: Elderly patients (N = 50) who underwent nonemergent thoracoscopic lobectomy in the thoracic surgery department of our hospital from January 2019 to December 2020 were selected and randomly divided into continuous erector spinae block (ESPB; n = 25) group and continuous thoracic paravertebral block (TPVB; n = 25) group. The patients in the two groups were guided by ultrasound with ESPB or TPVB before anesthesia induction. The visual analog scale at rest and cough in 2 hours, 6 hours, 8 hours, 12 hours, 24 hours, 48 hours after surgery, the supplementary analgesic dosage of tramadol, time of tube placement, the stay time in postanesthesia care unit (PACU), the first ambulation time after surgery, the length of postoperative hospital stay and postoperative complications were recorded.
RESULTS: There were no significant differences between the two groups in visual analog scale score at rest and cough at each time point and supplementary analgesic dosage of tramadol within 48 hours after surgery (P > .05). The time of tube placement and the postoperative hospital stay in ESPB group was significantly shorter than that in TPVB group (P < .05). There were no differences in PACU residence time and first ambulation time between the two groups (P > .05). There were 4 patients in TPVB group and 2 patients in ESPB group who had nausea and vomiting (P > .05), 1 case of pneumothorax and 1 case of fever in the TPVB group. There were no incision infections or respiratory depression requiring clinical intervention in either group.
CONCLUSIONS: Both ESPB and TPVB alleviated the patients postoperative pain effectively for elderly patients underwent thoracoscopic lobectomy. Compared with TPVB, patients with ESPB have a shorter tube placement time, fewer complications and faster postoperative recovery.
摘要：
目的：本研究的目的是比较超声引导下连续竖脊肌平面阻滞与连续胸椎旁阻滞对老年患者胸腔镜肺叶切除术后镇痛的效果。
方法：随机对照试验。
方法：选择2019年1月至2020年12月在我院胸外科行胸腔镜肺叶切除术的老年患者（N=50），随机分为连续竖脊肌阻滞（ESPB；n=25）组和连续胸椎旁阻滞（TPVB；n=25）组。两组患者麻醉诱导前均采用超声引导下ESPB或TPVB。2小时内休息和咳嗽时的视觉模拟量表，6小时,8小时,12小时,24小时,手术后48小时，曲马多的补充镇痛剂量，管放置的时间，在麻醉后监护室（PACU）的停留时间，手术后第一次下床活动时间,记录术后住院时间和术后并发症。
结果：两组患者术后各时间点静息、咳嗽视觉模拟评分及术后48h内补充曲马多的镇痛剂量比较，差异均无统计学意义（P>0.05）。ESPB组的置管时间和术后住院时间明显短于TPVB组（P<0.05）。两组PACU停留时间和首次下床时间差异无统计学意义(P>.05)。TPVB组4例,ESPB组2例出现恶心呕吐(P>0.05),TPVB组发生气胸1例，发热1例。两组均无切口感染或呼吸抑制需要临床干预。
结论：ESPB和TPVB均能有效缓解老年患者胸腔镜肺叶切除术后的疼痛。与TPVB相比,ESPB患者的置管时间较短，并发症少，术后恢复快。
方法：随机对照试验。
方法：选择2019年1月至2020年12月在我院胸外科行胸腔镜肺叶切除术的老年患者（N=50），随机分为连续竖脊肌阻滞（ESPB；n=25）组和连续胸椎旁阻滞（TPVB；n=25）组。两组患者麻醉诱导前均采用超声引导下ESPB或TPVB。2小时内休息和咳嗽时的视觉模拟量表，6小时,8小时,12小时,24小时,手术后48小时，曲马多的补充镇痛剂量，管放置的时间，在麻醉后监护室（PACU）的停留时间，手术后第一次下床活动时间,记录术后住院时间和术后并发症。
结果：两组患者术后各时间点静息、咳嗽视觉模拟评分及术后48h内补充曲马多的镇痛剂量比较，差异均无统计学意义（P>0.05）。ESPB组的置管时间和术后住院时间明显短于TPVB组（P<0.05）。两组PACU停留时间和首次下床时间差异无统计学意义(P>.05)。TPVB组4例,ESPB组2例出现恶心呕吐(P>0.05),TPVB组发生气胸1例，发热1例。两组均无切口感染或呼吸抑制需要临床干预。
结论：ESPB和TPVB均能有效缓解老年患者胸腔镜肺叶切除术后的疼痛。与TPVB相比,ESPB患者的置管时间较短，并发症少，术后恢复快。
