• Int J Surg · Sep 2018

    Randomized Controlled Trial

    Investigation of single-dose thoracic paravertebral analgesia for postoperative pain control after thoracoscopic lobectomy - A randomized controlled trial.

    • Wengang Ding, Yannan Chen, Dongmei Li, Lu Wang, Haopan Liu, Hongyan Wang, and Xianzhang Zeng.
    • Department of Anaesthesiology, Second Hospital of Harbin Medical University, 246 Xuefu Road, Harbin 150001, Heilongjiang, China. Electronic address: dingwg9999@163.com.
    • Int J Surg. 2018 Sep 1; 57: 8-14.

    BackgroundThoracoscopic lobectomy is less painful than normal thoracotomy, but pain management is still an issue in the postoperative period. Thoracic epidural analgesia (TEA) is considered as the gold standard for post-thoracotomy pain control, but is associated with numerous risks.MethodsA total of 114 patients undergoing thoracoscopic lobectomy were randomly divided into three groups. Patients in the PVB-R group received a single-dose 0.5% ropivacaine paravertebral block (PVB), combined with patient-controlled intravenous analgesia (PCIA) after extubation during the 48-h postoperative period; those in the PVB-RD group received a single-dose 0.5% ropivacaine and dexmedetomidine (1 μg/kg) PVB, combined with the same PCIA scheme; and those in the TEA group received intraoperative thoracic epidural anesthesia with 0.5% ropivacaine, and a single dose of epidural morphine (0.03 mg/kg) after extubation combined with the same PCIA scheme. The dose and first time of postoperative analgesia, verbal rating score (VRS), change in catecholamine, cortisol and cytokine levels, change in hemodynamic parameters, and side effects during the postoperative period were recorded.ResultsCompared to the PVB-R group, the dose of postoperative analgesia and VRS were lower and the first time of postoperative analgesia were longer in the PVB-RD and TEA group. Patients in the PVB-RD group had a lower incidence of side effects compared to those in the TEA group.ConclusionsSingle-dose 0.5% ropivacaine combined with dexmedetomidine (1 μg/kg) PVB provides satisfactory postoperative pain control after thoracoscopic lobectomy, and can reduce the incidence of postoperative side effects.Copyright © 2018. Published by Elsevier Ltd.

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