Effect of Ropivacaine Combined with Dexamethasone Thoracic Paravertebral Nerve Block on Postoperative Analgesia and Recovery Quality of Patients Un-dergoing Thoracoscopic Lobectomy
Huang Chenchen;Liu Jin;Wang Shuang;Affiliated Hospital of Xuzhou Medical University;
Objective To observe the effect of ropivacaine combined with dexa-methasone thoracic paravertebral nerve block(TPVB) on postoperative analgesia and recovery quality of patients undergoing thoracoscopic lobectomy. Methods Sixty patients who underwent thoracoscopic lobectomy in our hospital were randomly divided into two groups:control group(group R) and experimental group(group RD). Each group had 30 patients. Thoracic paravertebral nerve block was induced before anesthesia:Group R was injected with 0.5%ropivacaine 20 ml+2 ml normal saline(NS); Group RD was injected with 0.5%ropivacaine 20 ml+2 ml dexamethasone(10 mg). The onset time and duration of analgesia of TPVB were recorded, and the rest and movement(cough time) visual analogue score(VAS) and the grade of expectoration ability were recorded. The Qor-15 scoresof the quality of recovery scale on the first day and the second day after the operation were recorded, and the scores of the arthens Insomnia Scale on the night after the operation were recorded, and record the times of pressing the analgesia pump within 24 hours, and the occurrence of adverse reactions such as nausea and vomiting, pruritus and so on were recorded. Results Compared with group R, the duration of TPVB action in the group RD was significantly longer and the onset time was significantly shorter,and the number of pressionof analgesia pump decreased significantly within 24 hours(P0.05); the scores of resting and exercise VAS and the expectoration ability in the two groups were similar at 2,18,24 hours after operation(P0.05), and the scores of resting and exercise VAS in the group R were lower than those in the group RD at 4 hours after operation(P0.05).The rest VAS score of group R was lower than that of group RD(P0.05), but there was no significant difference in exercise VAS score(P0.05). The expectoration ability of group RD was higher in the 4 and 8 hours than group R(P0.05). Qor-15 score of group RD was lower than that of group R(P0.05). Compared with Group R, the sleep quality score of Group RD was lower than that of Group R(P0.05). There was no significant difference in the incidence of adverse reactions(P0.05). Conclusion Ropivacaine combined with dexamethasone TPVB can provide effective postoperative analgesia for patients undergoing thoracoscopic lobectomy, prolong the duration of analgesia, shorten the onset time, improve the ability of expectoration and sleep quality, and accelerate the recovery of patients.
【CateGory Index】： R614