Welcome to Chinese Journal of Clinical Pharmacology and Therapeutics,Today is Chinese

Chinese Journal of Clinical Pharmacology and Therapeutics ›› 2015, Vol. 20 ›› Issue (6): 669-672.

Previous Articles     Next Articles

Clinical evaluation of continual thoracic paravertebral block guided by nerve stimulator for pulmonary lobectomy with one-lung ventilation

  

  • Received:2014-11-10 Revised:2014-12-30 Online:2015-06-26 Published:2015-06-29

Abstract: Objective:Discuss the value of clinical application of continual thoracic paravertebral block guided by nerve stimulator for pulmonary lobectomy with one-lung ventilation. Methods:60 patients(ASAⅠ-Ⅱ)scheduled for pulmonary lobectomy with one-lung ventilation (OLV)were randomized into 2 groups : group G+P which combined thoracic paravertebral bolck with general anesthesia versus group G+C which combined thoracic epidural anesthesia with general anesthesia ,both groups inserted catheter into the paravertebral space and epidural space seperately for postoperative anagesia . Following indexes were recorded : MAP and HR at different times-points : before blockage (T0),15 mins after blockage(T1),5mins after patients were placed in lateral decubitus position with double-lung ventilation(T2),15 mins after one-lung ventilation (T3),30 mins after one-lung ventilation (T4),45 mins after one-lung ventilation (T5);Arterial blood gas and mixed venous blood gas; Pulmonary shunt fractions (Qs/Qt) ; PaO2 and PaCO2 at postoperative 2h .6h.12h.24h and 48h; Postoperative pain scores(VAS) both when patients were in quiescent condition (Resting VAS) and had a cough(Cough VAS) at postoperative 2h, 6h,12h.24h .48h . Results:MAP HR descended significantly at T1 than G+P at T0 in group G+C,which had statistical differences between the groups (P<0.05);pulmonary shunt fractions in both groups begun to advance at T2, and no significant statistical differences were noted between the groups(P>0.05); Postoperative Cough VAS in the G+P group at postoperative 6 h.12 h.24h was lower than it in the G+C group. Resting VAS in the G+P group at postoperative 12 h.24h was lower than it in the G+C group (P<0.05); Patients had a higher PaO2 at postoperative 2h and 6h in the G+P group than it in the G+C group (P<0.05). Conclusion:Thoracic Paravertebral block for surgery with one-lung ventilation which had less influences on hemodynamics , exact anaesthetic efficacies ,comparative influences on pulmonary shunt fractions to epidural anesthesia ,and resulted in better postoperative pain relief in motion and better oxygenation had clinical application value .