Objective  To investigate the effect of ultrasound-guided erector spinae plane block combined with general anesthesia on intraoperative analgesia and early postoperative outcomes in patients aged over 75 years undergoing lobectomy for lung cancer.

  Methods  In this study, we enrolled 63 patients with advanced lung cancer aged 75 years and older who were admitted to The Affiliated Hospital of Southwest Medical University between June 2018 and June 2019. All patients underwent lobectomy. Using the random number table method, patients were assigned into the control group (31 cases) and the observation group (32 cases). The control group received general anesthesia, while the observation group received ultrasound-guided erector spinae plane block in combination with general anesthesia. Operation- related indexes, postoperative recovery time, postoperative duration of hospitalization, changes in mean arterial pressure and heart rate at different time points during the operation, dosage of remifentanil during the operation, postoperative vital capacity, postoperative analgesic effects, postoperative rehabilitation quality, postoperative cognitive function, and adverse reactions were compared between the two groups.

  Results  There was no significant difference in operative time, anesthesia time, postoperative recovery time, or postoperative duration of hospitalization between the two groups (P>0.05). The mean arterial pressure and heart rate in the observation group were lower than those in the control group (P < 0.05) during intubation, skin cutting, and extubation; the vital capacities at 12 h, 24 h, and 48 h after the operation were higher in the observation group than in the control group (P < 0.05); the remediation rate of postoperative analgesia, number of compressions of the analgesia pump, total infusion volume, the visual analog scale scores at 6 h, 12 h, and 72 h post-operation in the observation group were lower than those in the control group (P < 0.05); the scores for rehabilitation quality at 24 h, 48 h, and 72 h post-operation in the observation group were higher than those in the control group (P < 0.05). The incidence of cognitive dysfunction at 6 h, 12 h, and 24 h post-operation in the observation group was lower than that in the control group (P < 0.05). The overall incidence of adverse reactions was 37.50% and 70.97% in the observation and control groups, respectively (P < 0.05).

  Conclusions  Ultrasound-guided erector spinae plane block combined with general anesthesia is effective for patients over 75 years of age undergoing lobectomy for lung cancer. The intraoperative analgesia is relatively stable. Furthermore, the patients' vital signs during operation are relatively stable, and the postoperative recovery of lung function is rapid. Other advantages of this approach include good quality of rehabilitation, low rate of postoperative analgesic remediation, an accurate anesthetic effect, low risk, and safety. In addition, patients only experience mild pain, have a low incidence of postoperative cognitive dysfunction, and have fewer adverse reactions. Therefore, it is worth promoting this approach.