Effect of ultrasound‐guided thoracic paravertebral block on perioperative analgesia in elderly patients undergoing video‐assisted thoracic lobectomy in China: An interventional clinical randomized controlled trial

BACKGROUND: The aim of this study was to investigate the analgesic effect and safety of ultrasound‐guided thoracic paravertebral block (UG‐TPVB) in Chinese elderly patients undergoing video‐assisted thoracic lobectomy (VATL) and to study the influence of aging factors on these effects. METHODS: This study was a single‐center, single‐blind, prospective, randomized, controlled trial. A total of 300 patients scheduled for VATL were recruited and randomly divided into the UG‐TPVB group (T group) and conventional anesthesia group (C group) according to the recruitment order, and subgroups were set up according to whether the age was ≥65 years old or not. The postoperative 12, 24, and 48 h static/dynamic visual analog scale (VAS) scores, intraoperative fentanyl consumption, postoperative extubation time, post‐anesthesia care unit (PACU) stay time, hospitalization days, postoperative complications, and other indicators were compared between the two groups. RESULTS: The postoperative 12, 24, and 48 h static/dynamic VAS scores of the T group were significantly lower than those of the C group. The intraoperative fentanyl consumption, postoperative extubation time, PACU stay time, and postoperative hospitalization days were significantly lower than those of the C group. The incidence of postoperative 48 h urinary retention in the T group was significantly lower than that in the C group. These advantages showed no significant difference or slight difference between elderly patients and nonelderly patients, indicating that UG‐TPVB did not influence the analgesic effect and safety of VATL patients by age or age difference. CONCLUSION: UG‐TPVB is an effective and safe perioperative analgesia method for elderly VATL patients. Its application improves the quality of life and prognosis of elderly VATL patients.