Objective To investigate the influence of thoracic paravertebral block combined with erector spinae plane block on the effect of recovery after general anesthesia in patients undergoing thoracoscopic pulmonary segmentectomy. Methods A total of 86 patients with pulmonary carcinoma or pulmonary benign nodules undergoing thoracoscopic pulmonary segmentectomy were randomly divided into control group or observation group, with 43 cases in each group. Patients in both groups underwent video⁃assisted thoracoscopic pulmonary segmentectomy. The control group received combined intravenous⁃inhalation general anesthesia and thoracic paravertebral block preoperatively, while the observation group received combined intravenous⁃inhalation general anesthesia and thoracic paravertebral block combined with erector spinae plane block preoperatively. Perioperative indices including surgical duration, anesthesia duration, thoracic catheter indwelling time, and postoperative length of hospital day, and mean arterial pressure (MAP), heart rate before anesthesia induction after entering the operating room (T0), 15 minutes of anesthesia maintenance (T1), and 5 minutes preoperatively (T2), as well as Visual Analogue Scale (VAS) score for pain at recovery, and 4, 12, 48, 72 hours postoperatively; in addition, serum prostaglandin E2, epinephrine, norepinephrine, cortisol levels preoperatively and 48 hours postoperatively, and the incidence rate of analgesic relief within 72 hours after surgery, as well as postoperative complications during hospitalization were compared between patients of the two groups. Results (1) There was no statistically significant difference in surgical duration, anesthesia duration, thoracic catheter indwelling time, and postoperative length of hospital stay between the two groups (P>0.05). (2) At T1, MAP and heart rate of both groups increased compared to at T0, and MAP and heart rate of the observation group were lower than those of the control group (P<0.05). At T2, MAP and heart rate of the control group were higher than that at T0, the heart rate was lower than that at T1, but MAP and heart rate of the observation group were lower than those of the control group (P<0.05). (3) Within 48 hours postoperatively, the VAS scores for pain of both groups increased gradually over time, and the VAS score for pain of the observation group was lower than that of the control group (P<0.05); furthermore, at 72 hours postoperatively, the VAS score for pain in the observation group was higher than that at recovery and 4 hours after operation, and the VAS score for pain in the control group was higher than that at recovery, 4 and 12 hours after operation, and the VAS score for pain in the observation group was lower than that in the control group (P<0.05). (4) The incidence rate of postoperative analgesic relief in the observation group was lower than that in the control group (P<0.05). (5) At 48 hours after operation, the levels of serum norepinephrine, epinephrine, cortisol and prostaglandin E2 in the two groups were higher than those before operation, and the levels of the above indexes in the observation group were lower than those in the control group (P<0.05). (6) The incidence rate of postoperative complications during hospitalization in the observation group was lower than that in the control group (P<0.05). Conclusion The application of combined intravenous⁃inhalation general anesthesia and thoracic paravertebral block combined with erector spinae plane block before thoracoscopic pulmonary segmentectomy is helpful to reduce the degree of postoperative pain, and the analgesic effect is superior to that of only combined intravenous⁃inhalation general anesthesia and thoracic paravertebral block, exerting a favorable safety.

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