Effects of ultrasound-guided paravertebral nerve block combined with general anesthesia on intraoperative stress response, hemodynamics and postoperative pain of patients undergoing laparoscopic cholecystectomy / 中国医师杂志

ABSTRACT

Objective:To observe the effects of ultrasound-guided paravertebral nerve block combined with general anesthesia on intraoperative stress response, hemodynamics and postoperative pain of patients undergoing laparoscopic cholecystectomy.Methods:A total of 92 patients undergoing elective laparoscopic cholecystectomy in Wuhan Third Hospital between January 2017 and August 2019 wereselected. They were divided into the control group (63 cases) and the observation group (29 cases) by voluntary. The control group were given simple general intravenous anesthesia, and the observation group were given ultrasound-guided paravertebral nerve block combined with general intravenous anesthesia. Changes in hemodynamic parameters and concentrations of blood angiotensin-Ⅱ (AT-Ⅱ) and cortisol (Cor) in the two groups were observed. The cerebral state indexes (CSI) of both groups were recorded, and pain degree of patients was evaluated with the visual analogue scale (VAS).Results:The mean arterial pressure (MAP) and heart rate (HR) of the observation group were higher than those of the control group at 30 min after anesthesia, 30 min after operation, 3 hours after operation ( P<0.05), the stroke volume variation (SVV) was lower than that of the control group ( P<0.05); the AT-Ⅱ, Cor and CSI in the observation group were lower than those in the control group at each time point ( P<0.05); The dosage of narcotic drugs in the observation group was significantly lower than that in the control group ( P<0.05); The recovery time of spontaneous breathing, recovery time, extubation time and respiratory satisfaction time in the observation group were less than those in the control group ( P<0.05), and the VAS scores at 3 h, 6 h and 12 h after operation in the observation group were lower than those in the control group ( P<0.05). Conclusions:Ultrasound-guided paravertebral nerve block combined with general anesthesia can effectively reduce the patient's stress response during laparoscopic cholecystectomy, with good analgesic effect, which is helpful to maintain the hemodynamic stability of patients.