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.

Gui-Ling Dong, Rong-En Qiu, Chen-Zhan Xu
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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.

右美托咪定作为罗哌卡因佐剂在胸椎旁阻滞联合竖椎平面阻滞中提高经根尖经导管主动脉瓣置入术后早期恢复质量
本研究旨在探讨右美托咪定(Dex)作为罗哌卡因辅助治疗胸椎旁阻滞(TPVB)联合竖脊肌平面阻滞(ESPB)对改善经根尖经导管主动脉瓣植入术(TAVI)后早期恢复质量和术后疼痛的效果。89例全麻下经根尖TAVI患者采用计算机生成的随机数列表分为RS组和RD组。RS组(n = 45)给予35 mL 0.5%罗哌卡因加5 mL生理盐水混合TPVB联合ESPB; RD组(n = 44)给予35 mL 0.5%罗哌卡因加1 μg/kg右咪唑(Dex)加5 mL生理盐水。RD组在术后12和24 h的QoR-15评分明显高于RS组,VAS评分明显低于RS组。RD组PCIA按压次数少于RS组。RD组术后舒芬太尼用量明显少于RS组。RD组术后48小时内首次使用氟比洛芬所需时间较RS组长,且氟比洛芬治疗剂量较少。两组在副作用发生率上没有差异。本研究结果提示,全麻下经根尖TAVI患者在TPVB联合ESPB中加入右美托咪唑加罗哌卡因可有效提高早期恢复质量,减轻术后疼痛。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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