Li Zhang, Zhibiao Xu, Yuyun Liu, Yuxiang Meng, Sumin Yuan, Zijie Ling, Ziwei Li, Su Liu, Hao Zhang, Linlin Zhao
{"title":"地塞米松和右美托咪定作为辅助局部麻醉混合物用于胸腔镜手术中竖脊肌平面阻滞联合前锯肌平面阻滞：一项前瞻性、随机对照试验。","authors":"Li Zhang, Zhibiao Xu, Yuyun Liu, Yuxiang Meng, Sumin Yuan, Zijie Ling, Ziwei Li, Su Liu, Hao Zhang, Linlin Zhao","doi":"10.23736/S0375-9393.25.18895-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>We aimed to investigate the effect of dexamethasone and dexmedetomidine in erector spinae plane block combined with serratus anterior plane block for thoracoscopic postoperative analgesia.</p><p><strong>Methods: </strong>Ninety-six patients undergoing thoracoscopic surgery were randomly divided into group R (0.375% ropivacaine + saline diluted to 40 mL), group RS (0.375% ropivacaine + 10 mg dexamethasone + normal saline diluted to 40 mL), group RM (0.375% ropivacaine + 1 μg/kg dexmedetomidine + normal saline diluted to 40 mL), and group RSM (0.375% ropivacaine + 10 mg dexamethasone + 1 μg/kg dexmedetomidine + normal saline diluted to 40 mL). All four groups underwent ultrasound-guided erector spinae plane block combined with serratus anterior plane block within 30 minutes before anesthesia induction. The primary outcome was duration of effective analgesia, defined as the time from the onset of block to the first use of PCIA. Secondary outcomes included postoperative NRS scores, opioid consumption, rescue analgesia, quality of recovery, and adverse effects.</p><p><strong>Results: </strong>The duration of effective analgesia for group RSM (1770.0 [858.0] min) was significantly longer than group R (975.0 [471.5] min, P<0.001), group RS (1072.0 [695.0] min, P<0.05) and group RM (1340.0 [630.0] min, P<0.05). Group RSM also lowered postoperative pain scores, reduced opioid consumption and rescue analgesia, and improved quality of recovery compared with group R, group RS and group RM (all P<0.05). There was no significant difference in adverse effects, except that less nausea and vomiting were observed in group RSM (P<0.05).</p><p><strong>Conclusions: </strong>Dexamethasone and dexmedetomidine as adjuvants to local anesthetic mixture in erector spinae plane block combined with serratus anterior plane block could prolong the duration of effective analgesia after thoracoscopic surgery.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Dexamethasone and dexmedetomidine as adjuvants to local anesthetic mixture in erector spinae plane block combined with serratus anterior plane block for thoracoscopic surgery: a prospective, randomized controlled trial.\",\"authors\":\"Li Zhang, Zhibiao Xu, Yuyun Liu, Yuxiang Meng, Sumin Yuan, Zijie Ling, Ziwei Li, Su Liu, Hao Zhang, Linlin Zhao\",\"doi\":\"10.23736/S0375-9393.25.18895-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>We aimed to investigate the effect of dexamethasone and dexmedetomidine in erector spinae plane block combined with serratus anterior plane block for thoracoscopic postoperative analgesia.</p><p><strong>Methods: </strong>Ninety-six patients undergoing thoracoscopic surgery were randomly divided into group R (0.375% ropivacaine + saline diluted to 40 mL), group RS (0.375% ropivacaine + 10 mg dexamethasone + normal saline diluted to 40 mL), group RM (0.375% ropivacaine + 1 μg/kg dexmedetomidine + normal saline diluted to 40 mL), and group RSM (0.375% ropivacaine + 10 mg dexamethasone + 1 μg/kg dexmedetomidine + normal saline diluted to 40 mL). All four groups underwent ultrasound-guided erector spinae plane block combined with serratus anterior plane block within 30 minutes before anesthesia induction. The primary outcome was duration of effective analgesia, defined as the time from the onset of block to the first use of PCIA. Secondary outcomes included postoperative NRS scores, opioid consumption, rescue analgesia, quality of recovery, and adverse effects.</p><p><strong>Results: </strong>The duration of effective analgesia for group RSM (1770.0 [858.0] min) was significantly longer than group R (975.0 [471.5] min, P<0.001), group RS (1072.0 [695.0] min, P<0.05) and group RM (1340.0 [630.0] min, P<0.05). Group RSM also lowered postoperative pain scores, reduced opioid consumption and rescue analgesia, and improved quality of recovery compared with group R, group RS and group RM (all P<0.05). There was no significant difference in adverse effects, except that less nausea and vomiting were observed in group RSM (P<0.05).</p><p><strong>Conclusions: </strong>Dexamethasone and dexmedetomidine as adjuvants to local anesthetic mixture in erector spinae plane block combined with serratus anterior plane block could prolong the duration of effective analgesia after thoracoscopic surgery.</p>\",\"PeriodicalId\":18522,\"journal\":{\"name\":\"Minerva anestesiologica\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-06-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Minerva anestesiologica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.23736/S0375-9393.25.18895-0\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Minerva anestesiologica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.23736/S0375-9393.25.18895-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
Dexamethasone and dexmedetomidine as adjuvants to local anesthetic mixture in erector spinae plane block combined with serratus anterior plane block for thoracoscopic surgery: a prospective, randomized controlled trial.
Background: We aimed to investigate the effect of dexamethasone and dexmedetomidine in erector spinae plane block combined with serratus anterior plane block for thoracoscopic postoperative analgesia.
Methods: Ninety-six patients undergoing thoracoscopic surgery were randomly divided into group R (0.375% ropivacaine + saline diluted to 40 mL), group RS (0.375% ropivacaine + 10 mg dexamethasone + normal saline diluted to 40 mL), group RM (0.375% ropivacaine + 1 μg/kg dexmedetomidine + normal saline diluted to 40 mL), and group RSM (0.375% ropivacaine + 10 mg dexamethasone + 1 μg/kg dexmedetomidine + normal saline diluted to 40 mL). All four groups underwent ultrasound-guided erector spinae plane block combined with serratus anterior plane block within 30 minutes before anesthesia induction. The primary outcome was duration of effective analgesia, defined as the time from the onset of block to the first use of PCIA. Secondary outcomes included postoperative NRS scores, opioid consumption, rescue analgesia, quality of recovery, and adverse effects.
Results: The duration of effective analgesia for group RSM (1770.0 [858.0] min) was significantly longer than group R (975.0 [471.5] min, P<0.001), group RS (1072.0 [695.0] min, P<0.05) and group RM (1340.0 [630.0] min, P<0.05). Group RSM also lowered postoperative pain scores, reduced opioid consumption and rescue analgesia, and improved quality of recovery compared with group R, group RS and group RM (all P<0.05). There was no significant difference in adverse effects, except that less nausea and vomiting were observed in group RSM (P<0.05).
Conclusions: Dexamethasone and dexmedetomidine as adjuvants to local anesthetic mixture in erector spinae plane block combined with serratus anterior plane block could prolong the duration of effective analgesia after thoracoscopic surgery.
期刊介绍：
Minerva Anestesiologica is the journal of the Italian National Society of Anaesthesia, Analgesia, Resuscitation, and Intensive Care. Minerva Anestesiologica publishes scientific papers on Anesthesiology, Intensive care, Analgesia, Perioperative Medicine and related fields.
Manuscripts are expected to comply with the instructions to authors which conform to the Uniform Requirements for Manuscripts Submitted to Biomedical Editors by the International Committee of Medical Journal Editors.
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