Effect of paravertebral nerve block combined with general anesthesia on intraoperative regional cerebral oxygen saturation in elderly patients undergoing thoracoscopic lobectomy
10.3760/cma.j.cn131073.20210326.00810
- VernacularTitle:椎旁神经阻滞联合全身麻醉对胸腔镜肺叶切除术老年患者术中局部脑氧饱和度的影响
- Author:
Wei ZHAO
1
;
Chao LI
;
Zhijiao WANG
;
Junmei SHEN
;
Huiqun JIA
Author Information
1. 河北医科大学第四医院麻醉科，石家庄 050011
- Keywords:
Nerve block;
Thoracic vertebrae;
Anesthesia, general;
Thoracoscopy;
Pneumonectomy;
Aged;
Brain;
Oxygen
- From:
Chinese Journal of Anesthesiology
2021;41(8):939-942
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of paravertebral nerve block (PVNB) combined with general anesthesia on intraoperative regional cerebral oxygen saturation (rScO 2) in elderly patients undergoing thoracoscopic lobectomy. Methods:Seventy American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes, aged 60-85 yr, with body mass index of 18-25 kg/m 2, were divided into 2 groups ( n=35 each) using a random number table method: general anesthesia group (group G) and PVNB combined with general anesthesia group (group PG). PVNB was performed at T 4 and T 6 with 0.5% ropivocaine 10 ml for each site under ultrasound guidance before induction of anesthesia in group PG.After induction of anesthesia, anesthesia was maintained with IV propofol and remifentanil, and a patient-controlled intravenous analgesia pump was connected at the end of operation.The maximum and minimum rScO 2 and cumulative time of rScO 2 below the baseline value were recorded.The rScO 2 was recorded before anesthesia (T 0), at 5 min before one-lung ventilation (T 1), at 5 min after one-lung ventilation (T 2) and at tracheal extubation (T 3). The length of postoperative hospital stay and complications within 30 days after operation were recorded. Results:Compared with group G, the minimum rScO 2 and rScO 2 at T 2 and T 3 were significantly increased, the incidence of postoperative cognitive dysfunction was reduced ( P<0.05), and no significant change was found in the other parameters mentioned above in group PG ( P>0.05). Conclusion:PVNB combined with general anesthesia can improve intraoperative rScO 2 and reduce the development of postoperative cognitive dysfunction in elderly patients undergoing thoracoscopic lobectomy.
