RESUMO
Objective To investigate the analgesic effect of ultrasound-guided vertical spinal block (ESPB) in elderly patients after thoracoscopic surgery.Methods 40 elderly patients,aged 60-75 years,were selected for selective thoracoscopic surgery.Patients were randomly divided into two groups,ESPB group (E group) and paravertebral block (PVB) group (P group).In the E group,0.33％ ropivacaine 30 ml was injected between the T5 vertebral body transverse and the erector spines before surgery,and 0.33％ ropivacaine 30 ml was injected into the thoracic paravertebral space of T5-T6 in the P group.Patients in both groups were treated with sufentanil for postoperative patient controlled analgesia (PCA).The dosage of remifentanil intraoperative and sufentanil postoperative,remedial cases recorded in post anesthesia care unit (PACU),numeric rating scale (NRS) score at postoperative 1 h,6 h,12 h and 24 h were recorded,and intraoperative hypotension,postoperative nausea and vomiting cases,and operation time were documented.Results There was no significant difference in remifentanil dosage between the two groups (P ＞ 0.05).The total consumption of sufentanil in group E 24 hours after operation was higher than that in group P (P ＜ 0.05).The operation time of ultrasound-guided nerve block in group E was shorter than that in group P (P ＜ 0.05).The number of PACU remedial cases in group E was higher than that in group P (P ＞ 0.05).The NRS score recorded at postoperative 1 h,6 h,12 h and 24 h show no difference.There was no significant difference in the incidence of nausea and vomiting and intraoperative hypotension in the two groups.Conclusions Ultrasound-guided single ESPB block provides postoperative analgesia,which is similar but weaker compared with PVB and easy to operate.