A study investigates the application of nerve stimulator-guided thoracic paravertebral nerve block (TPVB) plus general anesthesia(GA) in small-incision lung cancer surgery. Treatment for lung cancer depends on tumor histology, tumor extent, and other patient-specific factors; however, surgery remains the cornerstone in treating this disease, and it offers the only chance for long-term survival.

The postoperative pain resulting from small-incision lung cancer surgery wounds inhibits patients' effective breathing and coughing and reduces lung function, leading to CO2 accumulation, pneumonia, and atelectasis. Since one goal of preoperative risk stratification is to identify the patient's risks for perioperative pulmonary complications in the early stage after thoracic surgery is particularly important.

The total local anesthetic amount administered to each patient was 15 ml 0.5% ropivacaine. The patients in Group P underwent GA induction (the induction regimen was the same in the two groups) after we had completed TPVB. They received intravenous injections of midazolam 0.05 mg/kg, sufentanil 0.3 μg/kg, cisatracurium 0.1 mg/kg, and etomidate 0.3 mg/kg for anesthesia induction.

When performing TPVB, the local anesthetic is firstly localized in the puncture space, and then it diffuses along the intercostal nerves, followed by diffusing toward the superior and inferior grooves of paravertebral space. Thereby, the motor, feeling and sympathetic nerves are blocked, leading to ipsilateral somatic anesthesia.

This provides an effective anesthesia and analgesia for unilateral thoracic and abdominal surgery. In recent years, because positioning techniques in the nerve stimulator have improved the success rate of nerve blocks and reduced their risks, the application of nerve stimulators has become increasingly widespread in a variety of nerve block fields.

TPVB has been widely applied in breast cancer surgery. Many studies have shown that TPVB reduces postoperative pain and opioid consumption and that it has a beneficial (if limited) effect on the quality of recovery. Among all the techniques evaluated, only the addition of fentanyl and performing multilevel blocks were associated with improved acute analgesia. TPVB may even reduce CPSP for 6 months.

In conclusion, they showed that nerve-stimulator-guided TPVB-GA was superior to GA in that it required less medication, promoted a more rapid recovery, and caused fewer complications when applied in small-incision lung cancer surgery.

Epidural anesthesia plus general anesthesia (GA) have been widely used clinically. However, the application of TPVB plus GA (TPVB-GA) to small-incision lung cancer surgery is seldom reported. The aim of this study was to explore the feasibility, safety, and effectiveness of TPVB-GA to small-incision lung cancer surgery, and to provide a reference for it further clinical application.