The Clinical Study Of Ropivacaine Used In Thoracic Erector Spinal Plane Block Range

Objective: To explore the range of ropivacaine with different volume of 0.33% under ultrasound guidance for Erector Spinae Plane Block(ESPB),in order to provide a suitable volume of ropivacaine for postoperative analgesia after thoracoscopic surgery.Methods: Sixty patients(ASA grade I-III,aged 18-80 years old,weight 50-80 kg,height150-180 cm,BMI18-24kg/m2)scheduled for Video-assisted thoracic surgery from December 2019 to December 2020 in our hospital,were divided into three groups randomly.Ultrasound-guidance T5 erector spinal plane block was administered(corresponding volume of ropivacaine was given according to the group),E1 group: 0.33%ropivacaine 20 ml,E2 group: 0.33% ropivacaine 30 ml,E3 group: 0.33%ropivacaine 40 ml.After the block was completed,observe for 1 hour with the time points of 10 minutes,20 minutes,40 minutes and 60 minutes after block and then start the induction of anesthesia.Acupuncture is used to measure the block range of the back,side chest wall,and anterior chest wall(the back was divided by the distribution of spinal nerves and the spread from the back to the front chest wall was divided into six areas by the mark line on the body surface).The block is successful with more than two planes,and the block is effective with the lateral spread of T4-T9 on the back beyond the front axillary line.Results: The three groups of patients had no statistical difference in general data such as gender,age,height,weight,and BMI(P>0.05).The E2 and E3 groups had a wider lateral retardation spread than the E1 group,and the difference was statistically significant(P<0.05).The E2 and E3 groups had no statistical significance in the lateral retardation spread(P>0.05).The E3 group had a wider spread of back block than the E1 and E2 groups,and the difference was statistically significant(P<0.05),and the E2 group had a wider spread of back block than the E1 group,and the difference was statistically significant(P<0.05).The block onset time in the E2 and E3 groups was faster than that in the E1 group,and the difference was statistically significant(P<0.05).The difference in block onset time in the E2 and E3 groups was not statistically significant(P>0.05).There were no complications such as hematoma,pneumothorax,local anesthetic poisoning,and infection in the three groups of patients,and the difference was not statistically significant(P>0.05).Conclusion: 0.33% ropivacaine thoracic erector spinal plane block increases with volume,and the range of back block is wider.0.33%ropivacaine 30 ml and 40 ml thoracic erector spinal plane block is wider than 20 ml lateral block,and the onset time is shorter.0.33% ropivacaine20 ml thoracic erector spinal plane block is not suitable for postoperative analgesia after thoracoscopic surgery,but 30 ml and 40 ml can be used for it.Considering that the larger the volume is,the higher the risk of local anesthetic poisoning is,we recommend 0.33% ropivacaine 30 ml erector spinal muscle plane block for postoperative analgesia after thoracoscopic surgery.