Objective To observe the effects of adding dexamethasone to ropivacaine on the quality and duration of ultrasound-guided thoracic paravertebral block (TPVB) in Ivor-Lewis esophagectomy.
Methods Sixty adult patients undergoing Ivor-Lewis esophagectomy, 29 males and 31 females, aged 40-75 years, ASA physical status Ⅰ-Ⅲ, were allocated into the study. The patients were randomly divided into two groups by the digital table method: ropivacaine group (group R) and ropivacaine combined with dexamethasone group (group RD), 30 cases in each group. Before general anesthesia induction, TPVB was performed under ultrasound guidance. Group R was treated with 0.5% ropivacaine 15 ml + normal saline 3 ml, and group RD was treated with 0.5% ropivacaine 15 ml + dexamethasone 0.15 mg/kg plus normal saline diluted to 3 ml. The duration of analgesia, the number of effective compressions of the analgesic pump within 48 hours after the operation, and the number of cases of remedial analgesia were recorded. The VAS pain scores for rest and cough 2, 4, 8, 12, 24, and 48 hours after the operation were recorded. Adverse reactions within 24 hours and the occurrence of chronic pain 3 months after surgery were recorded.
Results The duration of analgesia in group RD was significantly longer than that in group R, and the number of effective compressions of the analgesic pump within 48 hours after the operation was significantly less than that in group R (P < 0.05). The VAS pain scores for rest and cough 2, 4, 8, 12, and 24 hours after the operation were significantly lower than those in group R (P < 0.05). There was no statistically significant difference in the rate of salvage analgesia and the incidence of adverse reactions within 24 hours after the operation between the two groups. The incidence of chronic pain in group RD was significantly lower than that in group R 3 months after surgery (P < 0.05).
Conclusion Addition of dexamethasone to ropivacaine significantly prolongs the duration of analgesia, enhances analgesic effect, and reduces the incidence of chronic postsurgical pain compared to plain ropivacaine of TPVB in Ivor-Lewis esophagectomy. |
