Effect of anesthesia factor on early postoperative outcome in patients undergoing video-assisted thoracoscopic pulmonary lobectomy: efficacy of ultrasound-guided erector spinae plane block combined with general anesthesia

Abstract

Objective To evaluate the effect of ultrasound-guided erector spinae plane block combined with general anesthesia on early postoperative outcome in patients undergoing video-assisted thoracoscopic pulmonary lobectomy. Methods Eighty-five patients of both sexes, aged 18-64 yr, with body mass index of 18-24 kg/m2, of American Society Anesthesiologists physical status Ⅱ or Ⅲ, undergoing elective video-assisted thoracoscopic pulmonary lobectomy, were divided into 2 groups using a random number table method: general anesthesia group(group GA, n=43) and ultrasound-guided erector spinae plane block combined with general anesthesia group(group ESP+ GA, n=42). Ultrasound-guided erector spinae plane block was performed after induction of general anesthesia, 0.5% ropivacaine 20 ml was injected in group ESP+ GA, and 0.9% normal saline 20 ml was injected in group GA. Both groups received patient-controlled intravenous analgesia with sufentanil after surgery. Tramadol was intramuscularly injcted as resue analgesic when visual analog scale score>3.Quality of Recovery-40 questionnaire was used to assess the early postoperative quality of recovery at 1 day before surgery and 1 and 2 days after surgery. The consumption of intraoperative remifentanil and postoperative sufentanil, requirement for rescue analgesics and occurrence of postoperative adverse reactions were recorded. Results Compared with group GA, the Quality of Recovery-40 questionnaire scores were significantly increased at 1 and 2 days after surgery, the consumption of intraoperative remifentanil and postoperative sufentanil was reduced, and the requirement for rescue analgesics and incidence of nausea and vomiting were decreased in group ESP+ GA(P<0.05). Conclusion Ultrasound-guided erector spinae plane block combined with general anesthesia can promote early postoperative outcome in patients undergoing video-assisted thoracoscopic pulmonary lobectomy. Key words: Nerve block; Anesthesia, general; Rehabilitation; Ultrasonography; Thoracoscopy