椎旁神经阻滞在电视胸腔镜手术术后镇痛中的应用效果OA

Objective To compare the analgesic efficacy of ultrasound-guided thoracic paravertebral block(UTPB)and in-travenous patient-controlled analgesia(PCIA)in patients undergoing video-assisted thoracoscopic surgery(VATS).Meth-ods Seventy-six patients who underwent VATS and were admitted to the Yingde People's Hospital,Guangdong Province from February 2023 to February 2025 were selected as study subjects.They were divided into a control group(38 cases)and an observation group(38 cases)by random number table method.The control group received postoperative PCIA for pain relief,while the observation group was treated with ultrasound-guided thoracic paravertebral injection of ropivacaine for analgesia.Pain levels at rest and during movement at various postoperative time points,pain characteristics at 12 h post-surgery,inflammatory factor levels at different time points,functional recovery time,lung function before and 48 h after surgery,and the incidence of postoperative adverse reactions were compared between the two groups.Results The resting pain levels at 1,6,and 24 h after surgery,as well as the pain levels during exercise at 1,6,24,and 48 h,in the observation group were lower than those in the control group,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in the pain locations between the two groups(P＞0.05),but there was a statistically signifi-cant difference in the nature of the pain(P＜0.05).The levels of inflammatory factors at 1,6,24,and 48 h after surgery in the observation group were all lower than those in the control group,and the differences were statistically significant(P＜0.05).The time for the first standing up,the first defecation,and the recovery of bowel sounds after surgery in the observation group were shorter than those in the control group,and the differences were statistically significant(P＜0.05).At 48 h after surgery,the first-second forced expiratory volume(FEV1)and forced vital capacity(FVC)in the observation group were higher than those in the control group,and the differ-ences were statistically significant(P＜0.05).The total rate of adverse reactions such as nausea/vomiting and dizziness in the observation group was lower than that in the control group,and the difference was statistically significant(P＜0.05).Con-clusion Postoperative application of UTPB in VATS patients provides superior analgesia compared to PCIA.It effectively suppresses early postoperative inflammatory responses,reduces pain,enhances postoperative mobility and pulmonary function recovery,and decreases the incidence of adverse reactions.