The Comparison Of Clinical Applications Of Postoperative Analgesia After Video-assisted Thoracoscopic Surgery Between Single-pass Erector Spinae Plane Block Under Ultrasonic Guidance And Epidural Analgesia

Objective:Compare the postoperative analgesic effect of video-assisted thoracoscopic surgery between single-pass erector spinae plane block under ultrasonic guidance and thoracic epidural analgesia as well as the complications.Discuss feasibilities and advantages of clinical erector spinae plane block applied in postoperative analgesia after thoracoscopic surgery under the ultrasonic guidance.Method:Select 66 patients who underwent the video-assisted thoracoscopic surgery and divide patients into two groups by random number table(n=33)as followings:Group E:single-pass erector spinae plane block group under the ultrasonic guidance(Single nerve block:0.5%ropivacaine 30 ml,dexmedetomidine 40μg),Group T:thoracic epidural analgesia group(Epidural analgesia pump:0.185%ropivacaine 200ml,4ml/h).Control other variables in the perioperative period and record patients’visual analog pain score(VAS score)in the resting and cough state in 2h,4h,24h and 48h postoperative follow-ups.Record postoperative opioid dosages and postoperative complications,besides,each data of the two group patients was analyzed for statistical differences.Results:There is no statistical difference in general data of two groups.1.VAS Score:There is no statistical difference(P>0.05)in VAS Score in 4h,24h and 48h postoperative follow-ups in patients’ resting and cough state between single-pass erector spinae plane block group under the ultrasonic guidance(Group E)and thoracic epidural analgesia group(Group T),while there is statistical difference(P<0.05)in VAS Score in 2h resting and cough state and the VAS Score of Group E was smaller than that of Group T.2.Opioid usage:There is no statistically significant difference(P>0.05)in usage times of two group patients’ 10mg morphine intramuscular injection.3.Postoperative complications:There is statistical difference(P<0.05)in incidence rate of blood pressure below the basic value 30%within 2 hours and nausea,vomiting after two group patients’ surgery.Conclusion:Single-pass erector spinae plane block’s postoperative analgesia effect on video-assisted thoracoscopic surgery under ultrasonic guidance is similar to that of epidural block analgesia,which has a relatively small influence on the hemodynamics of patients.The incidence of postoperative nausea and vomiting is low,which is feasible and advantageous in clinical practice.