Volume 20 Issue 2
Feb.  2022
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Article Navigation >  Chinese Journal of General Practice  > 2022  >  20(2): 216-219
LIU Lei, LI Hai-hui, FENG Tao, WU Zhang, TAO Jing, LIANG Qi-sheng. Effects of thoracic paravertebral nerve block on hemodynamics during induction of anesthesia and postoperative recovery in patients undergoing coronary artery bypass grafting[J]. Chinese Journal of General Practice, 2022, 20(2): 216-219. doi: 10.16766/j.cnki.issn.1674-4152.002316
Citation: LIU Lei, LI Hai-hui, FENG Tao, WU Zhang, TAO Jing, LIANG Qi-sheng. Effects of thoracic paravertebral nerve block on hemodynamics during induction of anesthesia and postoperative recovery in patients undergoing coronary artery bypass grafting[J]. Chinese Journal of General Practice, 2022, 20(2): 216-219. doi: 10.16766/j.cnki.issn.1674-4152.002316
shu

Effects of thoracic paravertebral nerve block on hemodynamics during induction of anesthesia and postoperative recovery in patients undergoing coronary artery bypass grafting

doi: 10.16766/j.cnki.issn.1674-4152.002316
  • 1.

    Department of Anesthesiology, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

Funds:

 KJ2019A0362

  • Received Date: 2021-09-18
    Available Online: 2022-03-04
    Abstract
  •   Objective  To investigate the effects of thoracic paravertebral nerve block (TPVB) on hemodynamics during induction of anesthesia and postoperative recovery in patients undergoing coronary artery bypass grafting (CABG).  Methods  Fifty patients were selected for elective CABG at the First Affiliated Hospital of Bengbu Medical College from August 2020 to August 2021. The patients were divided into two groups using the random number table method: TPVB combined with general anesthesia group (group P) and conventional general anesthesia group (group G), each group contained 25 patients. The mean arterial pressure (MAP) and heart rate (HR) before induction of anesthesia (T0), before tracheal intubation (T1), immediately after tracheal intubation (T2), 1 min (T3) and 5 min (T4) after tracheal intubation, intraoperative sufentanil dosage, postoperative mechanical ventilation time, the visual analogue scale (VAS) scores after extubation, 12 and 24 h postoperatively, 24 h 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 were (74.84±10.05) mm Hg (1 mm Hg = 0.133 kPa), (74.96±10.03) mm Hg, (74.72±9.18) mm Hg, which were lower than those of group G [(85.08±10.57) mm Hg, (89.16±10.00) mm Hg, (81.04±8.92)mm Hg, all P < 0.05]; HR at T2-T4 in group P were lower than those in group G (all P < 0.05). Intraoperative sufentanil dosage, postoperative mechanical ventilation time, and length of stay in the CSICU in the group P were less than those in group G (all P < 0.05). The VAS scores at all postoperative time points in the group P were lower than those in the group G (all P < 0.05). The number of cases of remedial analgesia at 24 h postoperatively in the group P was less than that in the 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 (all P > 0.05).  Conclusion  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.

     

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    • References(20)
  • [1]
    张俊杰, 李曼, 曹亚楠, 等. 罗哌卡因双侧胸椎旁神经阻滞对心肺转流心脏瓣膜手术后康复的影响[J]. 临床麻醉学杂志, 2017, 33(12): 1178-1180. doi: 10.3969/j.issn.1004-5805.2017.12.009
    [2]
    SINGH D, JAGANNATH S, PRIYE S, et al. The comparison of dexmedetomidine, esmolol, and combination of dexmedetomidine with esmolol for attenuation of sympathomimetic response to laryngoscopy and intubation in patients undergoing coronary artery bypass grafting[J]. Ann Card Anaesth, 2019, 22(4): 353-357. doi: 10.4103/aca.ACA_112_18
    [3]
    RAJ N. Regional anesthesia for sternotomy and bypass-beyond the epidural[J]. Paediatr Anaesth, 2019, 29(5): 519-529. doi: 10.1111/pan.13626
    [4]
    CHAKRAVARTHY M. Regional analgesia in cardiothoracic surgery: A changing paradigm toward opioid-free anesthesia?[J]. Ann Card Anaesth, 2018, 21(3): 225-227. doi: 10.4103/aca.ACA_56_18
    [5]
    NOSS C, PRUSINKIEWICZ C, NELSON G, et al. Enhanced recovery for cardiac surgery[J]. J Cardiothorac Vasc Anesth, 2018, 32(6): 2760-2770. doi: 10.1053/j.jvca.2018.01.045
    [6]
    MOLL V, MAFFEO C, MITCHELL M, et al. Association of serratus anterior plane block for minimally invasive direct coronary artery bypass surgery with higher opioid consumption: A retrospective observational study[J]. J Cardiothorac Vasc Anesth, 2018, 32(6): 2570-2577. doi: 10.1053/j.jvca.2018.04.043
    [7]
    EL SHORA H A, EL BELEEHY A A, ABDELWAHAB A A, et al. Bilateral paravertebral block versus thoracic epidural analgesia for pain control post-cardiac surgery: A randomized controlled trial[J]. Thorac Cardiovasc Surg, 2020, 68(5): 410-416. doi: 10.1055/s-0038-1668496
    [8]
    张瑜, 孙莹杰, 刁玉刚. 超声引导下双侧胸椎旁神经阻滞复合全麻在非体外循环冠状动脉搭桥术中的应用效果探讨[J]. 中国实用医药, 2021, 16(13): 48-51. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSSA202113012.htm
    [9]
    ARDON A E, LEE J, FRANCO C D, et al. Paravertebral block: Anatomy and relevant safety issues[J]. Korean J Anesthesiol, 2020, 73(5): 394-400. doi: 10.4097/kja.20065
    [10]
    D'ERCOLE F, ARORA H, KUMAR P A. Paravertebral block for thoracic surgery[J]. J Cardiothorac Vasc Anesth, 2018, 32(2): 915-927. doi: 10.1053/j.jvca.2017.10.003
    [11]
    吴佳, 陈龙, 陈悦, 等. 超声引导下胸椎旁神经阻滞对食管癌手术患者围术期应激反应的影响[J]. 中华全科医学, 2018, 16(11): 1826-1828, 1842. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201811018.htm
    [12]
    HORLOCKER T T, VANDERMEUELEN E, KOPP S L, et al. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-based guidelines (fourth edition)[J]. Reg Anesth Pain Med, 2018, 43(3): 263-309. doi: 10.1097/AAP.0000000000000763
    [13]
    SANTONASTASO D P, DE CHIARA A, RISPOLI M, et al. Real-time view of anesthetic solution spread during an ultrasound-guided thoracic paravertebral block[J]. Tumori, 2018, 104(6): NP50-NP52. doi: 10.1177/0300891618763212
    [14]
    汤姗, 刘丹彦. 胸椎旁神经阻滞在胸科手术应用中的研究进展[J]. 山东医药, 2018, 58(30): 109-112. doi: 10.3969/j.issn.1002-266X.2018.30.032
    [15]
    罗太君, 李坤, 高广阔, 等. 超声引导下单点和两点胸椎旁神经阻滞对胸腔镜手术患者血流动力学和应激反应的影响[J]. 临床麻醉学杂志, 2019, 35(7): 680-684. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ201907018.htm
    [16]
    SUN L, LI Q, WANG Q, et al. Bilateral thoracic paravertebral block combined with general anesthesia vs. general anesthesia for patients undergoing off-pump coronary artery bypass grafting: A feasibility study[J]. BMC Anesthesiol, 2019, 19(1): 101. doi: 10.1186/s12871-019-0768-9
    [17]
    高平, 闫晓燕, 高晓增. 右美托咪定复合罗哌卡因行胸椎旁神经阻滞在冠脉搭桥术中的应用及对术后镇痛的影响[J]. 中国临床研究, 2021, 34(7): 909-912. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCK202107010.htm
    [18]
    邓燕忠, 彭生, 刘佩蓉. 超声引导下椎旁神经阻滞复合全身麻醉对胸科手术血流动力学及恢复的影响[J]. 国际麻醉学与复苏杂志, 2019, 40(10): 927-930. doi: 10.3760/cma.j.issn.1673-4378.2019.10.007
    [19]
    吴丹, 雷李培, 张杰, 等. 连续胸椎旁神经阻滞复合全身麻醉对肺癌患者术后康复和免疫功能的影响[J]. 中华全科医学, 2019, 17(6): 1033-1036, 1041. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201906040.htm
    [20]
    王思嘉, 蔡宏伟. 椎旁神经阻滞和胸横肌平面阻滞在心脏换瓣手术中应用效果的对比[J]. 湖南师范大学学报(医学版), 2021, 18(2): 120-123. https://www.cnki.com.cn/Article/CJFDTOTAL-HNYG202102034.htm
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