To analyze the safety and effectiveness of intrathoracic vagus nerve block combined with general anesthesia in thoracoscopic lobectomy for lung cancer.

A total of 95 patients with primary lung cancer who underwent thoracoscopic lobectomy at Qianjiang Central Hospital from April 2020 to March 2024 were collected. According to different anesthesia methods, they were divided into a control group with 52 cases and a observation group with 43 cases. The control group was given general anesthesia. The observation group received vagus nerve block on the right side of the lower segment of the trachea under thoracoscopy combined with general anesthesia, and was administered 2.5 ml of 0.75% ropivacaine. Compared the hemodynamics, pulmonary function indicators, pulmonary CT imaging, postoperative pain intensity, postoperative rehabilitation status, and the occurrence of adverse reactions such as postoperative nausea, vomiting, dizziness, etc, between the two groups.

At thirty minutes and sixty minutes after the start of the operation, the heart rate (HR) and mean arterial pressure (MAP) levels of the patients in both groups were significantly lower than those before anesthesia induction, and the HR and MAP levels in the observation group were significantly lower than those in the control group (P<0.05). At forty minutes of one-lung ventilation, the peak airway pressure (Ppeak) and plateau airway pressure (Pplat) levels in the observation group [(21.02±2.87) cmH₂O, (20.74±2.79) cmH₂O] were significantly lower than those in the control group [(22.61±2.96) cmH₂O, (22.18±3.01) cmH₂O], while the dynamic lung compliance (Cdyn) level [(29.11±5.17) ml/cmH₂O] was significantly higher than that in the control group [(27.03±4.59) ml/cmH₂O] (P<0.05). The results of pulmonary CT imaging: There were 3 cases of pneumonia in the control group and 2 cases in the observation group after the operation, 1 case of atelectasis in the control group and 1 case in the observation group, 2 cases of pleural effusion in the control group and 1 case in the observation group, and the rest were normal. There was no significant difference between the two groups (P>0.05). At 6 hours, 12 hours, and 24 hours after the operation, the visual analogue pain scale scores in the observation group [(2.24±0.67) points, (3.61±0.94) points, (2.47±0.84) points] were significantly lower than those in the control group (2.63±0.81) points, (4.23±1.16) points, (3.06±0.63) points (P<0.05). At 2 days after the operation, the score of the quality of recovery-15 scale (QoR-15) in the observation group (151.34±6.25) points was higher than that in the control group (148.13±7.76) points (P<0.05). The observation group reported 13 postoperative adverse events (30.23%) lower than control group 24 cases (46.15%), there was no significant difference in the incidence of postoperative adverse reactions between the two groups (P>0.05).

Intrathoracic vagus nerve block combined with general anesthesia is feasible for thoracoscopic lobectomy. It can not only ensure the intraoperative ventilation efficiency and hemodynamic stability, but also provide good postoperative analgesia, rehabilitation effects, and safety for patients.