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Abstract Objective: To compare the effects of ultrasound-guided thoracic paravertebral nerve block(TPVB) and serratus plane block(SPB) on thoracoscopic surgery under general anesthesia with spontaneous breathing. Methods: Sixty patients aged 18~65 years, with BMI between 18~24 kg/m2 and ASA physical status Ior II, undergoing thoracoscopic surgery were selected. They were divided randomly into two groups: TPVB group and SPB group; both groups underwent ultrasound guided TPVB or SPB with 0.375% ropivacaine 20 mL before induction of anesthesia; the laryngeal mask was placed after intravenous anesthesia. Blood pressure, heart rate, arterial blood oxygen saturation (SaO2), end-tidal carbon dioxide partial pressure (PetCO2) were recorded before induction of anesthesia (T0), when spontaneous breathing was recoveried after anesthesia induction(T1), 30(T2) and 60(T3) minutes after onset of surgery, at the end of surgery(T4), and after recovery(T5). Visual analog scale(VAS) scores at rest and cough were recorded at different time-points: 2,4,6,12,24 and 48 h after surgery. The number of effective compressions for patient -controlled analgesia and the cumulative dosage of opioids drugs, duration of block and complications were recorded. Results: There were no significant differences in blood pressure, heart rate, SaO2 and PetCO2 among T0, T1, T2, T3, T4 and T5 between TPVB group and SPB group. The time of the sensory block was significantly longer in the SPB group than that of the TPVB group(P<0.05). The VAS at cough was lower than the TPVB group at 6 h, 12 h after surgery(P<0.05). The number of effective compressions for patient -controlled analgesia and the cumulative dosage of opioids drugs was lower in the SPB group than that of the TPVB group(P<0.05). Conclusion: Ultrasound-guided TPVB and SPB could be safe and effective for the thoracoscopic surgery under general anesthesia with spontaneous breathing. However, SPB could significantly prolong postoperative analgesia, reduce the total amount of opioids administration.
［Key words］ultrasound; thoracic paravertebral nerve block; serratus plane block; thoracoscopic surgery
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