A Randomized Controlled Trial Of B-ultrasound Paravertebral Analgesia For Rapid Recovery Of Stage I Lung Cancer

PURPOSE: To compare with analgesic equivalence and incidence of side effects in patients,undergone with minimally invasive lung cancer,were treated continuous paravertebral analgesia or traditional venous analgesia;2.To investigate the different effects on the stress and inflammation response、gastrointestinal function、pulmonary function and patient satisfaction,in the patients after radical surgery for minimally invasive lung cancer,who was anesthetized by patient controlled epidural analgesia or patient controlled intravenous analgesia.PATIENTS AND METHODS: In the early stage lung cancer patients who would undergo minimally invasive lung cancer radical surgery,15 male and 15 female patients were included in the continuous paravertebral analgesia group,meanwhile 15 male and 15 female patients were included in the traditional venous analgesia group;recording postoperative pain,analgesic-related side effects,inflammatory stress level,cough and expectoration ability,cardiopulmonary function,gastrointestinal function and patient satisfaction,then comparing and analysing these results to get some conclusions.All the patients in this trial would participate in the similar and essential preoperative examination,eliminating obvious contraindications,then we treated patients with the video-assisted anatomic single lobectomy and lymph node dissection by the same team.The postoperative control group used the traditional venous connection continuous analgesia device,the experimental group used the continuous paraspinal analgesia device;under the same other treatments.The measuring index was analyzed by Mann-whitney tests,and the counting index was analyzed by chi-square tests.To analyze the differential analgesic effects and patients’ tolerance of the two analgesic methods,and the differential effects on the enhanced recovery after surgery.RESULTS: Patients in the paravertebral group could achieve better analgesia after surgery,the associated side effects of analgesia such as nausea and vomiting,and the probability of intermittent use of an analgesia pump due to intolerance of side effects were also greatly reduced.Meanwhile,the paravertebral group patients also can better cooperate with clinicians for postoperative rehabilitation,the total postoperative lung recruitment was accelerated,average length of stay were shortened,and the surgical experience was improved.In addition,the cardiovascular stress response of patients in the paravertebral group was also reduced,and the recovery of gastrointestinal function was faster than that of venous group too.CONCLUSION: The analgesic effect of Doppler ultrasound-assisted continuous analgesia of the paravertebral canal was superior to that of the conventional intravenous analgesia group,and the incidence of side effects associated with analgesic drugs was lower.Patients have higher tolerance to paravertebral catheter continuous analgesia,higher postoperative comfort and higher patient satisfaction.However,continuous paravertebral analgesia requires higher operating requirements for operators than the anesthetist who selected intravenous analgesia pump,with a more complicated series operation.In summary,in professional well-equipped hospital,the postoperative analgesia model of continuous analgesia with paraspinal catheter assisted by Doppler ultrasound is worthy of wide promotion in clinical practice.