Dexmedetomidine as a Ropivacaine Adjuvant in a Thoracic Paravertebral Block Combined With an Erector Spinae Plane Block for Improving Early Quality of Recovery After Transapical Transcatheter Aortic Valve Implantation.

Abstract

The study aimed to investigate the effectiveness of dexmedetomidine (Dex) as an adjuvant for ropivacaine in a thoracic paravertebral block (TPVB) combined with an erector spinae plane block (ESPB) for improving early quality of recovery and postoperative pain after transapical transcatheter aortic valve implantation (TAVI). A total of 89 patients who were scheduled to undergo transapical TAVI under general anesthesia were allocated into Group RS and Group RD by using a computer-generated random-number list. Group RS (n = 45) received 35 mL of 0.5% ropivacaine with 5 mL of a normal saline mixture in TPVB combined with ESPB and Group RD (n = 44) received 35 mL of 0.5% ropivacaine with 1 μg/kg Dex in 5 mL of normal saline. The RD group exhibited significantly higher global QoR-15 scores with lower visual analog scale (VAS) scores at 12 and 24 h postoperatively than the RS group. The RD group needed fewer press times of PCIA than the RS group. The postoperative sufentanil consumption was significantly less in the RD group than that in the RS group. A longer time to first use of flurbiprofen with less remedial doses of flurbiprofen consumption within 48 h postoperatively was required for the RD group than that for the RS group. The two groups did not differ in the incidence of side effects. The findings of the study suggest that adding Dex to ropivacaine in TPVB combined with ESPB is effective in improving early quality of recovery and alleviating postoperative pain for patients undergoing transapical TAVI under general anesthesia.