Effects of Thoracic Paravertebral Block on Postoperative Anxiety and Depression for Patients Undergoing Thoracoscopic Lung Cancer Radical Surgery

Abstract

This study is aimed at investigating the effect of thoracic paravertebral block (TPVB) on the occurrence of chronic postoperative pain, postoperative anxiety, and depression in patients undergoing thoracoscopic radical lung cancer surgery. A total of 120 patients who underwent thoracoscopic radical lung cancer surgery in our hospital from June 2019 to March 2021 were included. There were 62 males and 58 females, with an age of 18-75 years old and a body mass index of 20-28 kg/m2. Patients were divided into two groups using the random number table method, TPVB group ( $n=60$ ) and normal saline group (control group, $n=60$ ). Two-point nerve block was performed at T5-6 and T6-7 levels. Patients in the TPVB group received nerve block with 15 mL of 0.375% ropivacaine hydrochloride, while those in the control group received 5 mL of 0.9% normal saline. The numeric rating scale (NRS) scores at rest and during movement at 24 and 48 hours after surgery and the number of times the button on the patient-controlled analgesia pressed at 24 h after surgery in two groups were recorded. All patients were followed up by outpatient visits or phone visits at 1 year after surgery and assessed using Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) pain scale and Hospital Anxiety and Depression Scale (HADS). According to the inclusion, exclusion, and drop-out criteria, 108 patients were finally included, with 52 patients in the TPVB group and 56 patients in the control group. There was no statistically significant difference between the two groups in terms of age, sex, height, body weight, body mass index, ASA classification, and operation time ( $P>0.05$ ). NRS pain scores at 24 h ( $P=0.01$ 08) and 48 h ( $P=0.0000$ ) after surgery, the number of times pressing patient-controlled analgesia at 24 h after surgery ( $P=0.0000$ ), the LANSS scores ( $P=0.0000$ ), HADS anxiety score ( $P=0.0000$ ), and depression scores ( $P=0.0000$ ) at 1 year after surgery in the TPVB group were both significantly lower than those in the control group. To sum up, ultrasound-guided TPVB can effectively relieve pain at 48 hours after thoracoscopic lung cancer radical surgery and chronic postoperative pain at 6 months after V thoracoscopic lung cancer radical surgery.