Effects of ultrasound-guided erector spinae plane block with dexmedetomidine combined with ropivacaine of the same dose and different concentrations on analgesic effect and rehabilitation quality of patients undergoing thoracoscopic wedge resection of the lung: a prospective, randomized, controlled trial

Abstract

Objective To investigate the analgesic effect and rehabilitation quality of patients undergoing thoracoscopic wedge resection of the lung under erector spinae plane (ESP) block with dexmedetomidine combined with the same dose and different concentrations of ropivacaine. Methods Seventy patients undergoing thoracoscopic wedge resection were randomly divided into groups A (n = 35) and B (n = 35). To perform ESP block, the groups were administered dexmedetomidine (0.5 μg/kg) combined with 30 mL of 0.33% ropivacaine or 20 mL of 0.5% ropivacaine, respectively, half an hour before general anesthesia induction. We compared the onset time of anesthesia, the block level, and the duration of the block between the two groups. The number of compressions of the analgesic pump within 24 h and 48 h postoperatively and the time of the first compression were noted. The visual analog scale (VAS) scores of static and cough at 0.5 h, 6 h, 12 h, 24 h, and 48 h postoperatively were noted. Furthermore, the 40-item quality of recovery questionnaire (QoR-40) score was recorded at 24 h postoperatively. In addition, we noted the time taken to get out of the bed for the first time, the length of hospital stay, analgesia satisfaction, and the occurrence of related adverse reactions and complications within 48 h postoperatively. Results The range of ESP block was wider in Group A than in Group B (P < 0.05). Group B had a significantly shorter onset time (P < 0.05) and lower static and cough VAS scores at 6 h and 12 h postoperatively (P < 0.05); this was associated with significantly fewer compressions of the analgesic pump within 24 h and 48 h postoperatively and significantly more time until the first compression of the analgesic pump was required (P < 0.05). Group B was associated with significantly superior QoR-40 scores 24 h postoperatively and significantly shorter time to get out of the bed for the first time than Group A (P < 0.05). Conclusion Dexmedetomidine combined with 0.5% ropivacaine for ESP block is better than 0.33% ropivacaine for overall analgesia and postoperative rehabilitation of patients undergoing thoracoscopic wedge resection. Trial registration ChiCTR2200058114, Date of registration: 30/03/2022.

Dexmedetomidine with different concentrations added to local anesthetics in erector spinae plane block: a meta-analysis of randomized controlled trials

“…We excluded trials if i.v. regional anesthetics were used ( 19 ), the control group used dexmedetomidine as well ( 20 ), or the blocks other than the erector spinae plane were performed ( 21 , 22 ).…”

Effects of intraoperative neuromonitoring (IONM) technology on early recovery quality in patients after thyroid surgery: A randomized controlled trial

“…The QoR-40 Questionnaire is a valid and reliable tool that is extensively used to assess the quality of postoperative recovery [ 12 , 13 ]. 40 items totaling five dimensions—emotional state, physical comfort, psychological support, physical independence, and pain—make up the QoR-40 Questionnaire.…”

Optimal concentration of ropivacaine for peripheral nerve blocks in adult patients: a protocol for systematic review and meta-analysis

“…[4][5][6] Currently, ropivacaine is the most commonly used local anaesthetic for PNB due to its lower toxicity in the central nervous system and heart. 7 8 The concentrations of ropivacaine used for PNB are various, and the efficacy and safety of different concentrations of ropivacaine have been compared in several RCTs, [9][10][11][12][13][14] but the results were inconsistent. Therefore, it is meaningful to perform a systematic review and meta-analysis to determine the optimal concentration of ropivacaine for PNB, which may provide longer analgesia without increasing the incidence of adverse effects.…”