Thoracoscopy-guided thoracic paravertebral block using dexmedetomidine in combination with ropivacaine for postoperative analgesia after thoracoscopic radical resection of lung cancer: a randomized controlled trial.
Ke-Wei Wu, Shu-Yu Deng, Xu-Feng Zhang, Da-Wei Zheng, Li-Hong Hu
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引用次数: 0
Abstract
Purpose: The aim of this trial was to evaluate the analgesic effect of dexmedetomidine combined with ropivacaine for thoracoscopic-guided thoracic paravertebral block (TTPB) after thoracoscopic radical resection (TRR) of lung cancer.
Methods: A total of 60 patients were enrolled from our hospital who underwent elective TRR of lung cancer and randomized into either a control group (group C) or a dexmedetomidine group (group D). Prior to incisional suturing, group C received ropivacaine alone for TTPB, while group D received dexmedetomidine combined with ropivacaine for TTPB. The primary outcome was the time to the first analgesic request (TFAR). The secondary outcomes included heart rate (HR), mean arterial pressure (MAP), Ramsay sedation score, and Numerical Rating Scale (NRS) scores (both at rest and during coughing) at the following time points: before the TTPB operation (T0), 1 h postoperatively (T1), 2 h postoperatively (T2), 6 h postoperatively (T3), 12 h postoperatively (T4), 24 h postoperatively (T5), as well as 48 h postoperatively (T6). Additional secondary outcomes included the patient-controlled intravenous analgesia (PCIA) sufentanil dosage at 48 h postoperatively, the incidence of adverse reactions, and postoperative recovery.
Results: Compared to group C, group D showed a longer TFAR, lower total PCIA sufentanil dosage at 48 h postoperatively, and lower NRS scores at all time points; Group D also had lower MAP and HR, higher Ramsay sedation scores from T1 to T3 after surgery, a higher incidence of drowsiness, and better postoperative recovery.
Conclusions: As an adjuvant in combination with ropivacaine, dexmedetomidine enhanced the analgesic effect of TTPB, prolonged the duration of analgesia, and reduced the time to first ambulation and hospital stay.
目的：评价右美托咪定联合罗哌卡因用于胸腔镜下肺癌根治性切除术（TRR）后胸椎旁阻滞（TTPB）的镇痛效果。方法：选取我院择期肺癌TRR患者60例，随机分为对照组（C组）和右美托咪定组（D组）。C组在切口缝合前单独使用罗哌卡因治疗TTPB， D组使用右美托咪定联合罗哌卡因治疗TTPB。主要观察指标为首次镇痛时间（TFAR）。次要结果包括TTPB术前（T0）、术后1 h （T1）、2 h （T2）、6 h （T3）、12 h （T4）、24 h （T5）、48 h （T6）各时间点的心率（HR）、平均动脉压（MAP）、Ramsay镇静评分、数值评定量表（NRS）评分（静息和咳嗽时）。其他次要结局包括术后48小时患者静脉自控镇痛（PCIA）舒芬太尼剂量、不良反应发生率和术后恢复情况。结果：与C组比较，D组TFAR更长，术后48 h舒芬太尼总PCIA剂量较低，各时间点NRS评分较低；D组MAP、HR较低，术后T1 ~ T3 Ramsay镇静评分较高，嗜睡发生率较高，术后恢复较好。结论：右美托咪定与罗哌卡因联用可增强TTPB的镇痛效果，延长镇痛时间，缩短首次下床时间和住院时间。临床试验注册：ChiCTR2400086347，注册28/06/2024。
期刊介绍：
The "Journal of Cancer Research and Clinical Oncology" publishes significant and up-to-date articles within the fields of experimental and clinical oncology. The journal, which is chiefly devoted to Original papers, also includes Reviews as well as Editorials and Guest editorials on current, controversial topics. The section Letters to the editors provides a forum for a rapid exchange of comments and information concerning previously published papers and topics of current interest. Meeting reports provide current information on the latest results presented at important congresses.
The following fields are covered: carcinogenesis - etiology, mechanisms; molecular biology; recent developments in tumor therapy; general diagnosis; laboratory diagnosis; diagnostic and experimental pathology; oncologic surgery; and epidemiology.
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