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Application of Vertical Spinal Muscle Planar Block Combined with Laryngeal Mask Retention for Autonomous Breathing in Thoracoscopic Lung Lobectomy Anesthesia |
HU Liqun, LI Li, FU Jinsong, et al |
Tongling Municipal Hospital, Anhui Tongling 244000, China |
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Abstract Objective:To investigate the efficacy and safety of spinal plane block combined with laryngeal mask self-help breathing in anesthesia for thoracoscopic pulmonary lobectomy. Methods:40 cases of patients with elective thoracoscopic lobectomy in our hospital were selected and randomly divided into the erector spine plane block combined with the laryngeal mask and retained spontaneous breathing anesthesia group(group C) and the double-lumen endotracheal intubation general anesthesia group (group S) with 20 in each.The concentration levels of plasma cortisol,norepinephrine and epinephrine were measured in the two groups before anesthesia induction (T1),10 minutes after the beginning of operation (T2),30 minutes after the beginning of operation (T3) and 10 minutes after the end of operation (T4);The highest PetCO2 (PetCO2max) and the lowest SpO2 (SpO2min) were recorded during surgery in the two groups;The operative time,anesthesia recovery time,hospitalization time,postoperative complications,postoperative VAS pain and surgeon's satisfaction were compared between the two groups.Results:Compared with T1, the levels of cortisol, norepinephrine and epinephrine at T2, T3 and T4 in both groups increased (P<0.05). At T2, T3 and T4, the contents of cortisol, norepinephrine and epinephrine in group C were lower than those in group S at the same time point (P<0.05). Compared with group S,patients in group C experienced increased PetCO2max (P<0.05),decreased SpO2min (P<0.05),shortened anesthesia recovery time and hospitalization time (P<0.05), decreased postoperative VAS pain score (P<0.05),and significantly decreased the incidence of postoperative laryngopharyngeal pain and hoarseness (P<0.05).There was no difference in operative time and surgeon's satisfaction between the two groups (P>0.05).Conclusion: The erector spinae plane block combined with laryngeal mask and retained spontaneous breathing in anesthesia is certain feasible for thoracoscopic lobectomy,which does not affects the surgical process and effectively inhibits the surgical stress response,accelerates patient recovery and reduces complications.
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