Effects Of Ultrasound-guided Thoracic Paravertebral Nerve Block On Hemodynamics During Induction Of Anesthesia And Postoperative Recovery In Patients Undergoing Coronary Artery Bypass Grafting

Objective To investigate the effects of ultrasound-guided thoracic paravertebral nerve block（TPVB）on hemodynamics during induction of anesthesia and postoperative recovery in patients undergoing coronary artery bypass grafting（CABG）.Methods 50 patients undergoing CABG in our hospital from August 2020 to August 2021 were divided into two groups using the random number table method,namely: TPVB combined with general anesthesia group（group P）and general anesthesia group（group G）,each group contained 25 patients.Group P received bilateral TPVB and general anesthesia under ultrasound guidance before anesthesia induction,and group G received routine general anesthesia.The mean arterial pressure（MAP）and heart rate（HR）before induction of anesthesia（T0）,before tracheal intubation（T1）,immediately after tracheal intubation（T2）,1min（T3）and 5 min（T4）after tracheal intubation;intraoperative sufentanil dosage;postoperative mechanical ventilation time;the visual analogue scale（VAS）scores after extubation,12 h and 24 h postoperatively;24h postoperative remedial analgesia cases;length of stay in the cardiac surgical intensive care unit（CSICU）,postoperative hospital stay;and postoperative adverse effects were all recorded and analyzed accordingly.Results MAP at T2 ～ T4 in group P was（74.84±10.05）,（74.96±10.03）,and（74.72±9.18）mm Hg,respectively,and were lower than those in group G（all P<0.05）;HR at T2～T4 in group P was（63.04±7.74）,（64.12±6.54）,and（62.48±7.08）times/min,respectively,and were lower than those in the G group（all P<0.05）.Intraoperative sufentanil dosage,postoperative mechanical ventilation time,and length of stay in the CSICU in the P group were（385.60±64.25）μg,（8.02±1.24）h,and（17.70±3.41）h,all of which were less than those in group G（all P<0.05）.The VAS scores at all postoperative time points in group P were lower than those in group G（all P<0.05）.The number of cases of remedial analgesia at 24 h postoperatively in group P was less than that in group G（P<0.05）.There was no statistically significant difference in the incidence of nausea and vomiting and pulmonary infection between the two groups（P>0.05）.Conclusions Ultrasound-guided TPVB can maintain stable hemodynamics during the induction period of anesthesia in patients undergoing coronary artery bypass grafting.It also alleviates postoperative pain,reduces the amount of analgesic drugs,and facilitates the early postoperative recovery of patients.