Effect of ropivacaine combined with bilateral thoracic paravertebral nerve block on surgical rehabilitation in cardiopulmonary bypass heart valve surgery / 临床麻醉学杂志

ABSTRACT

Objective To observe the effect of ropivacaine on bilateral posterior thoracic paravertebral nerve block for cardiopulmonary bypass.Methods A total of 142 patients undergoing elective cardiac valve surgery,68 males and 74 females,were randomly divided into two groupsgroup C (general anesthesia,n =69) and group P (general anesthesia+ paraverteral nerve block with ropivacaine,n=73).The changes of hemodynamics,BIS,anesthesia dose and postoperative anesthesia were observed before and after anesthesia,the time of mechanical ventilation,the duration of vasoactive drug support,ICU stay time,length of stay and hospitalization costs were recorded.Results Compared with group C,heart rate and blood pressure were more stable in group P,and the dosage of sufentanil was less [(130.6±5.0) μg vs (202.8±7.4) μg,P＜0.01],the patient was awakened quickly [(241.0±15.8) min vs (417.6±38.9) min,P＜0.05],and the time of mechanical ventilation [(466.0±22.9) min vs (657.8±49.4) min,P＜0.05] and ICU residence time [(22.1±1.0) h vs (34.1±3.6) h,P＜0.05] were shortened,the cost of hospitalization decreased [(72 360±1 565) yuan vs (78 420±2 094) yuan,(P＜0.05)].Conclusion Thoracic paravertebral nerve block anesthesia combined with general anesthesia is better than pure general anesthesia,in terms of maintaining intraoperative circulation stability,reducing the amount of anesthetic analgesic drugs,and early recovery of patients after surgery.