Effect of bilateral thoracic paravertebral block combined with general anesthesia on early recovery after Nuss procedure in patients with pectus excavatum
10.3760/cma.j.issn.0254-1416.2018.11.011
- VernacularTitle:双侧胸椎旁神经阻滞联合全身麻醉对漏斗胸患者Nuss术后早期恢复的影响
- Author:
Jinhu XUE
1
;
Zhisong LI
;
Zhongyu WANG
;
Yong WANG
;
Yanqiu AI
;
Jianjun YANG
;
Wei ZHANG
Author Information
1. 450002,郑州大学第一附属医院麻醉科
- Keywords:
Nerve block;
Thoracic vertebrae;
Anesthesia,general;
Rehabilitation;
Funnel chest
- From:
Chinese Journal of Anesthesiology
2018;38(11):1322-1324
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of bilateral thoracic paravertebral block (TPVB) combined with general anesthesia on early recovery after Nuss procedure in patients with pectus excavatum.Methods Sixty patients of both sexes with pectus excavatum,aged 8-18 yr,with body mass index＜ 18.5-32.0 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective Nuss procedure,were divided into 2 groups by using a random number table method:general anesthesia group (group GA,n=30) and bilateral TPVB combined with general anesthesia group (group TPVB+ GA,n=30).Bilateral TPVB was performed at the level of T5 under ultrasound guidance at 30 min before operation in group TPVB+GA.Anesthesia was induced by intravenous injection of fentanyl,propofol and rocuronium and maintained by inhalation of sevoflurane,intravenous infusion of remifentanil 0.1-0.5 μg · kg-1 · min-1,and intermittent intravenous boluses of rocuronium.Patients received patient-controlled intravenous analgesia after operation.Tramadol 1-2 mg/kg or dizocin 0.1 mg/kg was intravenously injected as rescue analgesic,maintaining visual analogue scale score ≤ 3 within 2 days after operation.The intraoperative consumption of remifentanil,postoperative consumption of snfentanil,requirement for rescue analgesia and development of nausea and retching/vomiting were recorded.Quality of recovery was assessed using the Quality of Recovery-15 at 1 and 2 days after operation.Results Compared with group GA,the intraoperative consumption of remifentanil,postoperative consumption of sufentanil,rate of rescue analgesia and incidence of nausea and vomiting were significantly decreased,and Quality of Recovery-15 scores were increased at 1 and 2 days after operation in group TPVB +GA (P＜0.05).Conclusion Bilateral TPVB combined with general anesthesia can reduce the perioperative consumption of opioids and is beneficial for the early recovery after Nuss procedure in patients with pectus excavatum.
