CLINICAL TRIAL article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1587477
The Effect Of Ultrasound-guided Thoracic Paravertebral Nerve Block Combined With Hydromorphone On Postoperative Analgesia And Inflammatory Response In Thoracoscopic Surgery: A Randomized Controlled Trial
Provisionally accepted
- Shifang People's Hospital, Shifang, China
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Objective: This study aims to explore the effects of a multimodal postoperative analgesia regimen of ultrasound-guided thoracic paravertebral nerve block combined with hydromorphone controlled intravenous analgesia on postoperative analgesia, early recovery, and traumatic inflammatory response in patients undergoing thoracoscopy surgery, providing a basis for clinical application.In this single-blind, randomized controlled trial (RCT), we enrolled 64 patients scheduled for thoracoscopic lobectomy of the lung. The patients were randomly assigned into two groups of thoracic paravertebral nerve block combined with hydromorphone postoperative analgesia group (T group) and hydromorphone postoperative patient-controlled analgesia group (H group) according to the random number table method. T group underwent thoracic paravertebral block with ropivacaine before induction of general anesthesia. H group is the control group. Both groups underwent patient-controlled intravenous analgesia (PCIA) after surgery, with the analgesic formula being 50 μg/kg of hydromorphone. The analgesic solution is prepared with 100mL of sodium chloride injection, a background dose of 2.0 mL/h, a patient-controlled analgesia (PCA) dose of 3mL, and a locking time of 15 minutes.Compared with H group, T group showed a significant decrease in visual analogue scale (VAS) scores and an increase in bruggrmann comfort scale (BCS) scores within 8 hours after surgery, and a decrease in opioid analgesic doses during and within 8 hours after surgery. The levels of serum CRP, IL-6, and TNF-α in T group were lower than those in H group at 24 hours after surgery. The first time patients in T group got out of bed after surgery was earlier than that in H group. Two groups of patients had no serious adverse reactions 2 Conclusion: Ultrasound guided thoracic paravertebral nerve block combined with hydromorphone intravenous patient-controlled analgesia can achieve good analgesic effects in thoracoscopic lobectomy surgery. It can reduce the amount of opioid drugs used during the perioperative period, alleviate the body's inflammatory response, and promote rapid recovery of patients. It has clinical application value. Study registration www.chictr.org.cn (ChiCTR2300074082); the date the first patient was enrolled in the study was 1 August 2023.
Keywords: Analgesia, Ultrasound-guided thoracic paravertebral block, Thoracoscopic surgery, Hydromorphone, Inflammation
Received: 29 Mar 2025; Accepted: 10 Jul 2025.
Copyright: © 2025 Zeng, Yu, Yang, Liao and Ouyang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yinghui Ouyang, Shifang People's Hospital, Shifang, China
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