Abstract
Objective To compare the effects of continuous paravertebral block analgesia and patient-controlled intravenous analgesia after minimally invasive radical esophagectomy for esophageal cancer and their effects on postoperative recovery. Methods A retrospective analysis was performed among 233 patients who underwent minimally invasive esophageal cancer radical operation and met the requirements, including 87 patients (group C) who were successfully placed with a continuous paravertebral block device under direct vision and 146 patients (group P) who used a patient-controlled intravenous analgesia device. Visual analogue pain score (VAS) at rest and in motion for 1, 3, 6, 12, 24, 36, and 48 hours after awakening, incidence of adverse reactions of the two analgesic methods, occurrence of pulmonary complications after operation, use of emergency analgesics, and hospital stay after operation was recorded. Results The VAS scores of group C in resting and active state at 1, 3, 6, 12, 24, 36, and 48 hours after operation were significantly lower than those of group P (P < 0.001). The incidence of adverse reactions, pulmonary complications, and the use of emergency analgesics in group C were lower than those in group P (P < 0.05). The hospitalization time of group C was significantly shortened, and the satisfaction degree of group C was significantly higher than that of group P (P < 0.05). Conclusion Paravertebral block is safe and effective for patients undergoing minimally invasive radical esophagectomy. The incidence of adverse reactions and complications is lower, and the satisfaction of postoperative analgesia is higher, which is beneficial to the rapid recovery of patients after operation.
Highlights
China is one of the countries with the highest incidence and mortality of esophageal cancer in the world [1]
Severe pain still exists after operation, which is mainly related to the stimulation of the thoracic drainage tube and intercostal nerve traction or injury. e severe and lasting pain after operation limits the patient’s cough and expectoration, leads to respiratory secretion retention, and causes complications such as hypoxemia, atelectasis, and pulmonary infection, and induces severe stress response and inhibits immune function [4]. erefore, good postoperative analgesia has positive significance for patients’ rapid recovery and perioperative safety [5]
A subcutaneous analgesic device modified by our center is a continuous paravertebral analgesia (CPVB) device, which is placed under intraoperative thoracoscopy
Summary
China is one of the countries with the highest incidence and mortality of esophageal cancer in the world [1]. With the development of minimally invasive surgical technology, the trauma of esophageal cancer patients has been greatly reduced [3]. Severe pain still exists after operation, which is mainly related to the stimulation of the thoracic drainage tube and intercostal nerve traction or injury. Thoracic paravertebral nerve block technology has been more and more used for postoperative analgesia of esophageal cancer [6]. A subcutaneous analgesic device modified by our center is a continuous paravertebral analgesia (CPVB) device, which is placed under intraoperative thoracoscopy. We compared the analgesic effect of the device with that of patient-controlled intravenous analgesia (PCIA) and explored the efficacy and safety of the improved analgesic device in clinical application. In group C, instead of opioid analgesics, which are used in group P, some drugs are used for postoperation
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