Effects of ropivacaine combined with dexmedetomidine on postoperative analgesia in patients undergoing single-hole thoracoscopic lobectomy under ultrasound-guided anterior serratus plane blocking
FU Jiannan, QI Yanfang, CHEN YU, LIU Xiaomei
Department of Anesthesiology,the Sixth Medical Center of PLA General Hospital,Beijing 100048,China
Abstract：Objective To observe the effect of ultrasound-guided anterior serratus plane blocking by ropivacaine combined with dexmedetomidine on postoperative analgesia in patients undergoing single-hole thoracoscopic lobectomy.Methods A total of 150 patients undergoing single-hole thoracoscopic lobectomy in our hospital between January 2019 and April 2020 were randomly divided into three groups:group R,group RD,and group C(control group) ,with 50 cases in each.After surgery,patients in group R underwent ultrasound-guided anterior serratus plane blocking with 0.375% ropivacaine 20 ml,patients in group RD with 0.375% ropivacaine and 0.5 μg/kg dexmedetomidine 20ml,and group C with NS 20 ml.The three groups of patients were given intravenous analgesia pumps postoperatively.VAS scores and the number of effective presses at the analgesic pump were calculated before surgery,2 ,6,12,24,and 48 h after surgery.The incidence of adverse reactions such as nausea and vomiting,itching,hypotension,bradycardia and respiratory depression with 48 h of surgery was also recorded.Results VAS scores and effective numbers of presses at the analgesic pump were lower in group R than in group C at 2,6 and 12 h after surgery(P<0.05).VAS scores and effective numbers of presses at the analgesic pump in group RD were lower than in group C at 2,6,12 and 24 h after surgery(P<0.05).VAS scores and effective numbers of presses at the analgesic pump in group RD were lower than in group R at the above time points(P<0.05).The total incidence rate of adverse reactions in the three groups was 14%,16% and 42% respectively,while that of adverse reactions in group RD and group R was significantly lower than that of group C(P<0.05).Conclusions Ropivacaine combined with dexmedetomidine for SAPB can significantly reduce postoperative pain of patients undergoing single-hole thoracoscopic lobectomy,reduce the usage of opioid and incidence rate of postoperative nausea,vomiting and hypotension,which should be made more accessible.
Nagahiro I,Anodu A,Aoe M,et al.Pulmonary function,postoperative pain,and serum cytokine level after lobectomy:a comparison of VATS and conventional proceduer[J].Ann Thorac Surg,2001,72(2):362-365.
[2]
Perez M A,Lopezlvarez S,Fadrique F A,et al.Quality of postoperative recovery after breast surgery.general anaesthesia combined with paravertebral versus serratus-intercostal block[J].Rev Esp Anestesiol Reanim,2016,9356(16):30001-30004.
[3]
Park M H,Kim J A,Ahn H J,et al.A randomised trial of serratus anterior plane block for analgesia after thoracoscopic surgery[J].Anaesthesia,2018,73(10):1260-1264.
Boohwi H,Chae S L,Hyemin K,et al.Thoracic paravertebral block with adjuvant dexmedetomidine in video-assisted thoracoscopic surgery:a randomized,double-blind study [J].J Clin Med,2019,8(3):352-353.
Chen G D,Li Y F,Zhang Y X,et al.Effects of serratus anterior plane block for postoperative analgesia after thoracoscopic surgery compared with local anesthetic infiltration:a randomized clinical trial[J].J Pain Res,2019,34(12):2411-2417
[15]
Luan H F,Zhang X B,Feng J Y,et al.Effect of dexmedeto-midline added to ropivacaine onultrasound-guided-trans versus abdominis plane block for postoperativeanal-gesia after abdominal hysterectomy surgery:A prospective randomized controlled trial[J].Minerva Anestesiol,2016,82(9):981-988.
Marhofer D,Kettner S C,Marhofer P,et al.Dexmedetomidine as an adjuvant to ropivacaine prolongs peripheral nerve block:A volunteer study[J].Br J Anaesth,2013,110(3):438-442.
[18]
Yang Y X,Ou M C,Zhou H Y,et al.Effect of Scalp nerve block with ropivacaine on postoperative pain in patients undergoing craniotomy:a randomized,double blinded study [J].Sci Rep,2012,10(3):25-29.
[19]
Brummett C M,Hong E K,Janda A M,et al.Perineural dexmedetomidineadded toropivacine for sciatic nerve block in rats prolongs the duration of analgesia byblocking the hyper polarization-activated cation current[J].Anesthesiology,2011,115(4)836-843.
2020, Vol. 31 
