Effect of ultrasound-guided thoracic paravertebral block on perioperative stress reaction in patients undergoing esophageal carcinoma surgery

Objective To observe the effect of ultrasound-guided thoracic paravertebral block (TPVB) on perioperative stress response in patients undergoing radical surgery for esophageal carcinoma, and evaluate the safety and effectiveness of TPVB. Methods Total 60 patients with esophageal carcinoma surgery in People's Hospital of Hangzhou Medical College from December, 2017 to May, 2018 were selected and divided into control group and observation group. The control group was treated with general anesthesia merely, while the observation group was treated with general anesthesia combined with TPVB. The intraoperative blood volume, operative time, anesthesia recovery time, tube drawing time and dosage of anesthetic drugs were compared between the two groups. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and oxygen saturation (SpO₂) were observed before anesthesia induction, endotracheal intubation, during the operation process and after surgery. VAS pain scores were recorded and compared immediately after tube drawing and 1, 3, 5, 12, 24 h later. Before anesthesia induction, entrance the breast, close the breast, 1 h and 2 h after surgery, the concentration of stress-related serological indexes such as peripheral blood sugar, epinephrine (E), serum inflammatory factor interleukin-6 (IL-6) and interleukin-10 (IL-10) were detected. Results When compared with control group, the intraoperative blood volume, operative time, anesthesia recovery time, tube drawing time and dosage of anesthetic drugs in observation group were superior; the changes of SBP, DBP, HR and SpO₂ were stable during perioperative period. The VAS pain score at each time was lower than that in control group. Peripheral blood sugar, epinephrine (E), IL-6 and IL-10 were lower than that in control group. Conclusion Ultrasound-guided thoracic paravertebral block can improve the anesthetic effect, reduce anesthetic sum, inhibit the stress reaction in patients with esophageal carcinoma surgery and improve analgesic effect after surgery, which is worthy of popularization in clinical application.