Effect of thoracic paravertebral block combined with general anesthesia on early postoperative recovery of patients undergoing laparoscopic cholecystectomy

Abstract

Objective To evaluate the effect of thoracic paravertebral block (PVB) combined with general anesthesia on the early postoperative recovery of patients undergoing laparoscopic cholecystectomy. Methods Sixty patients of both sexes, aged 45-64 yr, with body mass index of 18.5-32.0 kg/m2, with American Society of Anesthesiologists physical status Ⅰ or Ⅱ, were divided into 2 groups (n=30 each) using a random number table method: general anesthesia group (group GA) and thoracic PVB combined with general anesthesia group (group TPGA). Thoracic PVB was performed under ultrasound guidance at the right vertebral level T7 at 30 min before operation, and 0.375% ropivacaine 0.4 ml/kg was intermittently injected when air or blood was not found after withdrawing from the catheter at the angle between the T7 transverse process and the pleura in group TPGA.Lidocaine was injected for local infiltration anesthesia, and patients received no thoracic PVB at 30 min before operation in group GA.Patient-controlled intravenous analgesia (PCIA) was performed with sufentanil after operation in two groups.When the visual analogue scale score ≥4 points, tramadol 1-2 mg/kg or dizocin 0.1 mg/kg was intravenously injected for rescue analgesia.The intraoperative consumption of remifentanil, postoperative effective pressing times of PCIA, consumption of sufentanil within 2 days after operation, requirement for rescue analgesia, and development of nausea and vomiting were recorded.Quality of Recovery-15 was used to assess the early postoperative quality of recovery at 1 and 2 days after operation. Results Compared with group GA, the intraoperative consumption of remifentanil, postoperative effective pressing times of PCIA, consumption of sufentanil within 2 days after operation, rate of rescue analgesia and incidence of nausea and vomiting were significantly decreased, and Quality of Recovery-15 scores were increased at 1 and 2 days after operation in group TPGA (P<0.05). Conclusion Compared with general anesthesia, thoracic PVB combined with general anesthesia is helpful in promoting early postoperative recovery when used for the patients undergoing laparoscopic cholecystectomy. Key words: Nerve block; Anesthesia, general; Recovery