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| Effect of Dexmedetomidine Combined with Ropivacaine on Thoracic Paravertebral Nerve Block in Patients with Esophageal Cancer Resection |
| CHEN Xiao-hong |
| Suining City Central Hospital, Sichuan Province 629000 |
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Abstract 【Objective】To investigate the effects of dexmedetomidine (Dex) combined with ropivacaine on analgesia, stress reaction and inflammatory reaction through the application of thoracic paravertebral nerve block (TPVB) in patients with esophageal cancer radical resection. 【Methods】A total of 60 patients with esophageal cancer underwent thoracotomy were randomly divided into two groups, with 30 cases in each group. The observation group was given Dex combined with ropivacaine and the control group was given ropivacaine alone for application of TPVB. The MAP, HR and BIS (bispectral index) were recorded before injection (T0), 30min after injection (T1), immediately after endotracheal intubation (T2), excision of tumor (T3) and at the end of operation (T4). The VAS (visual analogue scale) scores and postoperative analgesia pump control delivery times at different time points within 48 h after surgery were compared in the two groups. The concentrations of cortisol, c-reactive protein, TNF- α and IL-6 were measured before surgery and 3h, 24h and 48h after operation. 【Results】There was no difference in MAP and HR at different time points in the two groups (P>0.05). Compared to pre-operation, the BIS of the two groups decreased at T1~T4 (P<0.05).The VAS scores at different time points were lower in observation group than in the control group (P＜0.05). Also, the postoperative analgesia pump control delivery times within 48 h after surgery were lower than those in the control group (P＜0.05). There were no significant differences in preoperative concentrations of cortisol, c-reactive protein , TNF- α and IL-6 between the two groups (P>0.05). The concentrations of the above indexes were significantly increased at 3 h, 24 h and 48 h after surgery. However, the increase of the observation group was lower than that of the control group (P＜0.05). 【Conclusion】Dex combined with ropivacaine in TPVB can significantly prolong the effect of nerve block, improve postoperative analgesia, and decrease the stress reaction and inflammatory reaction in the patients with esophageal cancer undergoing thoracic surgery.
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Received: 28 April 2018
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2019, Vol. 36 
