JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE) ›› 2021, Vol. 41 ›› Issue (1): 66-69.doi: 10.3969/j.issn.1674-8115.2021.01.011

• Clinical research • Previous Articles     Next Articles

Application of ultrasound-guided cervical vagal block combined with thoracic paravertebral block in thoracoscopy

Chen CHENG(), Kun FAN, Ying ZHANG()   

  1. Department of Anaesthesiology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
  • Online:2021-01-28 Published:2021-02-22
  • Contact: Ying ZHANG E-mail:chchen249@163.com;zhang198069ying@163.com
  • Supported by:
    Funding Information] Project of Shanghai Sixth People's Hospital East(DY2019022)

Abstract: Objective

·To evaluate the safety and effectiveness of ultrasound-guided cervical vagal block combined with thoracic paravertebral block in resection of pulmonary bullae by thoracoscopy.

Methods

·Forty patients, scheduled for the resection of pulmonary bullae by thoracoscopy in the East Branch of Shanghai Sixth People's Hospital, Shanghai Jiao Tong University from Jan. 2019 to Feb. 2020, were randomly divided into two groups (n=20 each): general anaesthesia with double lumen tube (GA+DLT) group and non-intubated nerve block anaesthesia (NINBA) group. The GA+DLT group was treated with combined general anaesthesia and patient controlled intravenous analgesia (PCIA). In the NINBA group, cervical vagal block and thoracic paravertebral block were performed under the guidance of ultrasound, and 40 mL of 0.5% ropivacaine was given. Intraoperative cough, intraoperative hemorrhage, intraoperative hypoxemia, operation time, postoperative chest distress, visual analogue score (VAS) of sport, incidence of nausea and vomiting, time of parecoxib sodium use, postoperative hospital stay and Bruggermann Comfort Score (BCS) were recorded. SPSS 19.0 software package was used for statistical analysis. The data were expressed as x±s with t test for group comparison, and χ2 test was used for qualitative data.

Results

·There was no hypoxemia and cough in the two groups, and there was no significant difference in blood loss and operation time. The VAS of sport of the NINBA group was lower than that of the GA+DLT group (P=0.008); the time of using parecoxib sodium of the NINBA group was less than that of the GA+DLT group (P=0.000); the BCS of the patients in the NINBA group was significantly higher than that of the GA+DLT group (P=0.020). Compared with the NINBA group, the incidence of postoperative nausea and vomiting was higher in the GA+DLT group.

Conclusion

·Ultrasound-guided cervical vagal block combined with thoracic paravertebral block can be safely and effectively used in the resection of pulmonary bullae by thoracoscopy.

Key words: vagal block, thoracic paravertebral block, ultrasound-guided, thoracoscopy, resection of pulmonary bullae

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