To investigate the effect of bilateral thoracic paravertebral nerve block(BTPVB)combined with general anesthesia on bridging vascular flow in OPCABG.
Fifty patients were randomly divided into two groups randomly:BTPVB combined with general anesthesia group (T group,n=20) and general anesthesia group (G group,n=30). Before anesthesia induction, the patients in group T underwent bilateral thoracic paravertebral space puncture through T4-5 space. The experimental dose of 1% lidocaine 5 ml was injected on both sides, and the first dose of 0.375% ropivacaine 15 ml was given 2 minutes later.Primary Outcome Measures: Immediate flow and pulse index of bridge vessels were recorded in both groups. Secondary Outcome Measures: Dosages of intraoperative anesthetic drugs were recorded in both groups. After the placement of the floating catheter (T1), after the sternotomy (T2), after the completion of anastomosis of all bridging vessels (T3), and before the exit of the chamber (T4), HR MAP, CVP, MPAP, CCO, SVRI and PVRI were recorded.
The level of pain block after BTPVB in T group was 5.1 and 0.6 segments, as shown and G group, and CVP at T3 and T4 in T group SVRI and PVRI were significantly decreased (P<0.05), and CCO was significantly increased (P<0.05). Compared with group G, the incidence of tachycardia in the operation center in group T was significantly decreased (P<0.05), the incidence of hypotension and the use rate of noradrenaline were significantly increased (P<0.05), and the intraoperative sufentanil in group T was significantly decreased (P<0.05).Compared with group G, after OPCABG, the blood flow of the lima-lad bridge in group T was significantly increased (P<0.05), and the vascular pulse index of the bridge was significantly decreased (P<0.05).
BTPVB combined with general anesthesia has obvious analgesic effect significantly increased the vascular flow of the left internal thoracic artery bridge and decreased the vascular pulse index of the left internal thoracic artery bridge after OPCABG.
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