Effects of thoracic paravertebral nerve block at different time points on postoperativelong-term quality of life in patients undergoing thoracoscopic radical resection of lung cancer
10.3760/cma.j.issn.0254-1416.2019.09.006
- VernacularTitle: 不同时机胸椎旁神经阻滞对胸腔镜肺癌根治术患者术后远期生活质量的影响
- Author:
Yao LIU
1
;
Bing LI
2
;
Xing MENG
2
;
Jiaqiang ZHANG
2
;
Wei ZHANG
2
Author Information
1. Department of Anesthesiology, Zhengzhou People′s Hospital, Zhengzhou 450003, China
2. Department of Anesthesiology, People′s Hospital of Zhengzhou University (Henan Provincial People′s Hospital), Zhengzhou 450003, China
- Publication Type:Journal Article
- Keywords:
Nerve block;
Thoracoscopes;
Lung neoplasms;
Quality of life
- From:
Chinese Journal of Anesthesiology
2019;39(9):1047-1050
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of thoracic paravertebral nerve block (TPVB) at different time points on postoperative long-term quality of life in the patients undergoing thoracoscopic radical resection of lung cancer.
Methods:One hundred and fifty patients of both sexes, aged 25-64 yr, with body mass index of 18-24 kg/m2, of American Society of Anesthesiologists physical status Ⅰor Ⅱ, scheduled for elective radical resection of lung cancer, were divided into 3 groups (n=50 each) by a random number table method: preoperative TPVB group (P1 group), TPVB at the end of operation group (P2 group) and preoperative TPVB combined with TPVB at the end of operation group (P3 group). In group P1, TPVB was performed at T4, 6 points on the affected side under ultrasound guidance before anesthesia induction, and 0.5% ropivacaine 10 ml was injected in total.In group P2, TPVB was performed at T4, 6 points on the affected side under ultrasound guidance at the end of operation, and 0.5% ropivacaine 10 ml was injected in total.In group P3, TPVB was performed at T4, 6 points on the affected side under ultrasound guidance before anesthesia induction and at the end of operation, and 0.5% ropivacaine 10 ml was injected each time.The analgesia pump was connected at the end of operation in three groups.The patients were followed up after operation, and 5 ml solution extracted from the analgesic pump was intravenously injected when VAS score was greater than or equal to 4.The occurrence of postoperative chronic pain in the 3 groups was recorded though telephone follow-up at 6 and 12 months after surgery, and the effect of pain on daily life and treatment measures were scored.A concise health-related quality of life scale was used to evaluate patients′ quality of life, and the physical and mental health scores were calculated.
Results:There was no significant difference in the incidence of chronic pain at 6 and 12 months after surgery among the three groups (P>0.05). The physical and mental health scores were significantly decreased at 12 months after surgery than at 6 months after surgery in the three groups (P<0.05). Compared with P1 and P2 groups, the scores of effect of pain on daily life and treatment measures were significantly decreased, and the physical and mental health scores were increased at 12 months after surgery in group P3 (P<0.05).
Conclusion:The combination of preoperative TPVB and TPVB at the end of operation can effectively improve postoperative long-term quality of life in the patients undergoing thoracoscopic radical resection of lung cancer.
