Optimized strategy of anesthesia for thoracoscopic radical resection of lung cancer: erector spinae plane block combined with general anesthesia / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the efficacy of erector spinae plane block (ESPB) combined with general anesthesia when used for thoracoscopic radical resection of lung cancer.Methods Forty patients of both sexes,aged 30-64 yr,with body mass index of 18-24 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective thoracoscopic radical resection of lung cancer,were divided into 2 groups (n =20 each) using a random number table method:ESPB combined with general anesthesia group (group EG) and general anesthesia group (group G).ESPB was performed before anesthesia induction,and 20 min later the effect was evaluated by testing the area of block in group EG.Anesthesia was induced with midazolam,propofol,sufentanil and cisatracurium and maintained with sevoflurane and remifentanil to maintain the bispectral index value between 40 and 60.Patient-controlled intravenous analgesia was applied in both groups at the end of operation,flurbiprofen axetil 100 mg was intravenously injected as a remedy for analgesia when necessary,and the visual analog scale score was maintained less than or equal to 3.The intraoperative consumption of sulfentanil and remifentanil,emergence time from anesthesia and time of tracheal extubation were recorded.The development of adverse effects within 48 h after operation,postoperative length of hospital stay,requirement for rescue analgesia and patients' overall satisfaction with postoperative analgesia were also recorded.Results Compared with group G,the intraoperative consumption of sulfentanil and remifentanil was significantly decreased,the emergence time from anesthesia and time of tracheal extubation were shortened,the incidence of nausea and vomiting within 48 h after operation was decreased,the first occurrence time was prolonged,the requirement for rescue analgesia was decreased,postoperative length of hospital stay was shortened,and patients' satisfaction scores were increased in group EG (P＜0.05).Conclusion ESPB combined with general anesthesia can reduce the perioperative consumption of opioids and is helpful in improving prognosis when used for thoracoscopic radical resection of lung cancer.