The application of LMA-astrach laryngeal mask combined with paravertebral nerve and stellate ganglion block in thoracoscopic surgery with reserved spontaneous breathing

ObjectiveTo evaluate the safety and efficacy of LMA-Fastrach laryngeal mask combined with paravertebral nerve and stellate ganglion block in thoracoscopic surgery.

MethodsEighty patients treated with thoracoscopic surgery under general anesthesia were randomly divided into the group T and group M.The group T were treated with conventional double lumen bronchial anesthesia, and the group M were treated with LMA-Fastrach laryngeal mask combined with paravertebral nerve and stellate ganglion block anesthesia.The incidence rates of postoperative pharynx pain, hoarseness and atelectasis in two groups were observed and recorded.The results of arterial blood gas analysis and airway pressure in two groups after intubation(T₀), after 10 min of operation(T₁), after 30 min of operation(T₂) and before 10 min of the end of operation(T₃) were analyzed.The total intraoperative anesthetic dose, extubation time and recovery room residence time were recorded in two groups.The VAS score, sleep quality and inflammatory cytokines content after 2 h(T₄), 24 h(T₅) and 48 h(T₆) of surgery were recorded.

ResultsThere was no statistical significance in the incidence rates of pharynx pain, hoarseness and atelectasis between two groups(P>0.05).The perioperative usage of remifentanil and sufentanil, endotracheal extubation time and recovery room residence time in group T were higher than those in group M(P < 0.01).The analgesia score and inflammatory factors in group T were higher than those in group M at T₄ time point(P < 0.01).The analgesia score, sleep quality score and inflammatory factors in group T were higher than those in group M at T₅ time point(P < 0.01).The analgesia score and sleep quality score in group T were higher than those in group M at T₆ time point(P < 0.01 and P < 0.05).The airway pressure in group T was significantly higher than that in group M at T₁(P < 0.01).The PaO₂ and airway pressure in group T were higher than those in group M at T₂(P < 0.05 and P < 0.01).The PaO₂ in group T at T₃ was significantly higher than that in group M (P < 0.01).

ConclusionsThe LMA-Fastrach laryngeal mask combined with paravertebral nerve and stellate ganglion block is safe and effective in thoracoscopic surgery.