关键词: 肋间神经阻滞；超声引导椎旁神经阻滞；胸腔镜手术

Abstract: Objective This study compared the effects of intraoperative intercostal nerve block (ICNB) and preoperative ultrasound-guided paravertebral block (US-PVB) on postoperative complications in patients undergoing thoracoscopic lung surgery.Methods Data from 240 patients who underwent video-assisted thoracoscopic lung surgery under general anesthesia between January 2019 and December 2020 was retrospectively collected.These patients either received intraoperative intercostal nerve block (ICNB) （202 cases)or pre-operative ultrasound-guided paravertebral block (US-PVB)(38 cases).The incidence rates of overall postoperative complications,postoperative pulmonary complications,postoperative cardiac complications,postoperative cerebral complications,other postoperative complications,remedial analgesia requirement in the PACU,intraoperative fentanyl consumption,postoperative oral morphine equivalent (OME),perioperative OME,duration of postoperative drainage tube,postoperative ICU stay,and postoperative hospital stay were compared between the ICNB group and the US-PVB group.Univariate and multivariate regression were used to analyze the effects of different analgesia methods on postoperative complicationsResults There was no statistically significant difference in postoperative overall complications between the ICNB group and the US-PVB group(P>0.05).In the univariate analysis,no significant difference was found in the overall postoperative complications between the ICNB group (16.3%) and the US-PVB group (13.2%)(OR=0.642,95%CI 0.239-1.786;P=0.404.Multivariate analysis also did not reveal any differences between the two groups (OR=0.843,95%CI 0.299-2.377;P=0746).For the analysis of secondary outcomes,according to multivariate analysis,there was no significant difference between the two groups in postoperative pulmonary complications,postoperative cardiac complications,other postoperative complications,remedial analgesia requirement in the PACU,intraoperative fentanyl consumption,postoperative OME,perioperative OME,duration of postoperative drainage tube,postoperative ICU stay or postoperative hospital stay(P>0.05).Conclusion In this study,we found no difference in postoperative complications between intraoperative ICNB and preoperative US-PVB.

Key words: intercostal nerve block；ultrasound-guided paravertebral block；thoracoscopic surgery