Effects Of Ultrasound-guided Paravertebral Nerve Block On Postoperative Delirium In Elderly Patients Undergoing Thoracoscopic Pulmonary Surgery

Objective: To investigate the effect of ultrasound-guided paravertebral nerve block on postoperative delirium in elderly patients undergoing thoracoscopic pulmonary surgery.Methods:Selected forty cases patients from The Affiliated Tumor Hospital of Guangxi Medical University(Nanning,China),undergoing thoracoscopic pulmonary surgery,No gender,aged≥60 yr,ASAⅠ-Ⅲ;The score of mini-mental state examination(MMSE)was≥24.All the the patients who met the criteria were ranked,and the patients were randomly divided into two groups in a 1:1ratio according to the Numbers generated by the computer:general anesthesia group(group S)and ultrasound-guided paravertebral nerve block group(group P).Patients in group P received the same general anesthesia and ultrasound-guided paravertebral nerve block in operation side before anesthesia induction.Routine postoperative analgesia.The hemodynamics(including blood pressure and heart rate)of 9 time nodes were recorded,T1(before anesthesia induction),T2(after anesthesia induction),T3(before skin resection),T4(after skin resection),T5(after surgery),T6(after extubation),T7(one day after surgery),T8(two days after surgery),and T9(three days after surgery).Record the patient’s general information and intraoperative relevant information;The patient’s time of resuscitation(from the end of surgery to resuscitation),extubation(from resuscitation to extubation),PACU time,and postoperative hospital stay were recorded.Visual analogue score(VAS),analgesic drug use,occurrence of delirium,and occurrence of complications were counted in the wake period and postoperative day 1,2,and 3.Statistical results P < 0.05 were statistically significant.Results: Delirium was less in group P than in group S(P < 0.05).VAS score and amount of analgesic drugs in group P during the waking period were lower than those in group S(P < 0.05),and there was no statistically significant difference in VAS score and amount of analgesic drugs between groups,1 to 3 days after the operation.The dosage of propofol,remifentanil,wake time,extubation time,PACU time and postoperative hospital stay in group P were reduced compared with group S,but there was no significant difference.There were no significant differences in general conditions,hemodynamics and postoperative complications between the two groups.Conclusion: Ultrasound-guided paravertebral nerve block can reduce the incidence of postoperative delirium in elderly patients undergoing thoracoscopic pulmonary surgery.