Thoracic Paravertebral Nerve Block with Ropivacaine and Adjuvant Dexmedetomidine Produced Longer Analgesia in Patients Undergoing Video-Assisted Thoracoscopic Lobectomy: A Randomized Trial

Author:

Zha Jun1ORCID,Ji Shiliang2ORCID,Wang Chen1ORCID,Yang Zhe1ORCID,Qiao Shigang13ORCID,An Jianzhong3ORCID

Affiliation:

1. Department of Anesthesiology and Perioperative Medicine, The Affiliated Suzhou Science & Technology Town Hospital of Nanjing Medical University, No. 1 Lijiang Road, Suzhou 215153, China

2. Department of Pharmacy, The Affiliated Suzhou Science & Technology Town Hospital of Nanjing Medical University, No. 1 Lijiang Road, Suzhou 215153, China

3. Institute of Clinical Medicine Research, The Affiliated Suzhou Science & Technology Town Hospital of Nanjing Medical University, No. 1 Lijiang Road, Suzhou 215153, China

Abstract

Purpose. This study evaluated the postoperative analgesic effect of ultrasound-guided single-point thoracic paravertebral nerve block (TPVB) combined with dexmedetomidine (DEX) in patients undergoing video-assisted thoracoscopic lobectomy. Methods. Sixty adult patients of the American Society of Anesthesiologists (ASA) I–III were randomly assigned into three groups (n = 20 each). G group: patients received routine general anesthesia; PR group: patients received 0.5% ropivacaine; and PRD group: patients received 0.5% ropivacaine with 1 μg/kg DEX. TPVB was performed in the T5 space before surgery, and then, general anesthesia induction and video-assisted thoracoscopic lobectomy were performed. Analgesics were administered through the patient-controlled analgesia (PCA) device intravenously. The background infusion of each PCA device was set to administer 0.02 μg/kg/h sufentanil, with a lockout time of 15 min, and a total allowable volume is 100 ml. Results. Compared to PR and G groups, the total sufentanil consumption after operation, the times of analgesic pump pressing, the pain score, and the incidence of postoperative nausea or vomiting in the PRD group were significantly reduced ( p < 0.05 ). Also, the duration of first time of usage of the patient-controlled analgesia (PCA) was longer. The heart rate (HR) and mean arterial pressure (MAP) during operation were lower in the PRD group as compared with the other two groups in most of the time. However, hypotension and arrhythmia occurred in three groups with no statistically significant difference. Conclusions. A small volume of TPVB with ropivacaine and DEX by single injection produced longer analgesia in patients undergoing video-assisted thoracoscopic lobectomy, reduced postoperative opioids consumption, and the incidence of side effects.

Funder

Jiangsu Key Talent Youth Awards in Medicine

Publisher

Hindawi Limited

Subject

Health Informatics,Biomedical Engineering,Surgery,Biotechnology

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