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Randomized Controlled Trial
. 2021 Sep 8:2021:1846886.
doi: 10.1155/2021/1846886. eCollection 2021.

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

Jun Zha  1 , Shiliang Ji  2 , Chen Wang  1 , Zhe Yang  1 , Shigang Qiao  1   3 , Jianzhng An  3
Affiliations
Randomized Controlled Trial

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

Jun Zha et al. J Healthc Eng. .

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.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
CONSORT flow diagram of the study.
Figure 2
Figure 2
Postoperative NRS.R. Values in all groups. Values in the PRD group compared to the G group and the PR group at all time points. There was no difference between the G group and PR group (p > 0.05).
Figure 3
Figure 3
Postoperative NRS.M. Values in all groups. Values in the PRD group compared to the G group and the PR group at all time points (p < 0.05). There was no difference between the G group and PR group.
Figure 4
Figure 4
Intraoperative heart rate values in all groups. The PRD group compared to the G group and PR group except at 40 minutes and 60 minutes (∗p < 0.05).
Figure 5
Figure 5
Intraoperative MAP values in all groups. The PRD group compared to the G group and PR group except at 20 min and 100 min (∗p < 0.05). There were significant differences between the G group and PR group at 60, 80, and then 100 min; the G group and PRD group at all time points except 20 min; and the PR group and PRD group at 20 and 100 min (p < 0.05).
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