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.
Highlights
Video-assisted thoracoscopic surgery (VATS) is mainly used for the treatment of the lung, mediastinum, and pleural lesions. e main advantage is to avoid the injury of thoracotomy
A large body of literature has shown that the duration of analgesia is controversial, and paravertebral block (PVB) is only beneficial immediately after surgery [6, 7]. ere are few studies on the effectiveness and tolerability of adjuvant analgesics in paraspinal analgesia. e addition of magnesium, clonidine, ketamine, dexamethasone, opioids, and other analgesics and local anesthetics can enhance and prolong the analgesic effect provided by PVB [8, 9]
E gender, age, American Society of Anesthesiologists (ASA) grade, height, weight, body mass index (BMI), heart rate (HR), mean artery pressure (MAP) baseline, duration of surgery (h), anesthesia (h), the time to first analgesic request since paravertebral injection (TFR1), first use of patient-controlled analgesia (PCA1) intravenously, total sufentanil dosage, and the pressing times of analgesic pumps were all recorded in three groups. e intraoperative mean arterial pressure (MAP) and HR were measured after starting thoracic paravertebral nerve block (TPVB) bolus injection
Summary
Video-assisted thoracoscopic surgery (VATS) is mainly used for the treatment of the lung, mediastinum, and pleural lesions. e main advantage is to avoid the injury of thoracotomy. E gender, age, ASA grade, height, weight, body mass index (BMI), heart rate (HR), mean artery pressure (MAP) baseline, duration of surgery (h), anesthesia (h), the time to first analgesic request since paravertebral injection (TFR1), first use of patient-controlled analgesia (PCA1) intravenously, total sufentanil dosage, and the pressing times of analgesic pumps were all recorded in three groups. 3. Results ere were no significant differences among the G group, PR group, and PRD group in demographic data such as age, weight, height, BMI, and baseline hemodynamic parameters durations of surgery and anesthesia (p > 0.05) (Table 1). Ere was no significant difference of postoperative Ramsay sedation scores among all groups before 12 h; the score values in the G group were significantly lower than that in the PR or PRD group (p < 0.05; Table 3).
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
