Effects of Different Doses of Dexmedetomidine Combined with Thoracic Paravertebral Nerve Block Anesthesia on Agitation and Hemodynamics in Patients Undergoing Thoracotomy during Recovery

Abstract

Objective. To investigate the effect of different doses of dexmedetomidine combined with thoracic paravertebral nerve block anesthesia on agitation and hemodynamics in patients undergoing thoracotomy during recovery. Methods. One hundred patients who underwent thoracotomy in our hospital from August 2018 to April 2021 were enrolled and assigned (1 : 1 : 1 : 1) into 4 groups via the random number table method. The patients in the control group were treated with double-lumen tube general anesthesia + ropivacaine for thoracic paravertebral nerve block anesthesia; patients in experimental group A received double-lumen general anesthesia +0.5 μg·kg−1 dexmedetomidine + ropivacaine for thoracic paravertebral nerve block anesthesia; patients in experimental group B received thoracic paravertebral nerve block anesthesia with double-lumen general anesthesia +1.0 μg·kg−1 dexmedetomidine + ropivacaine; patients in experimental group C received thoracic paravertebral nerve block anesthesia with double-lumen general anesthesia +1.5 μg·kg−1 dexmedetomidine + ropivacaine. The postoperative recovery time and visual analog scale (VAS), level of hemodynamics (heart rate (HR), mean arterial pressure (MAP)), agitation during the recovery period, and complications were compared amongst the 4 groups of patients at different time points. Results. The postoperative VAS scores of patients in groups B2 and B3 were slightly lower than those of patients in groups A and B1, but a one-way analysis of variance revealed no statistical difference in the postoperative recovery time and VAS pain scores of the four groups ( $P>0.05$ ), and the recovery time of patients in experimental group C was slightly higher than that of patients in group B2. At T0 and T1, there was no significant difference in the levels of HR and MAP among the four groups ( $P>0.05$ ). The levels of HR and MAP of the patients in groups B2 and B3 were significantly different from the patients in the control group and experimental group A at T2 and T3 ( $P<0.05$ ). The patients in experimental group B and experimental group C showed better outcomes than those in the control group and experimental group A in the assessment of agitation during the recovery period ( $P<0.05$ ). There was no significant difference in the incidence of complications among the four groups ( $P>0.05$ ). Conclusion. In line with the principle of preference for a small anesthesia dose, 1.0 μg·kg−1 dose of dexmedetomidine combined with ropivacaine produces a pronounced efficacy in patients undergoing thoracotomy. It effectively controls the occurrence of agitation during the recovery period and maintains the stability of the patient’s hemodynamics, with a high clinical safety profile.