Effect Of Dexmedetomidine Combined With Ropivacaine During The Ultrasound(US)-guided Erector Spine Plane Block On Postoperative Analgesia For Patients Undergoing Hepatectomy

Objective: To evaluate the effect of dexmedetomidine combined with ropivacaine during the ultrasound(US)-guided erector spine plane block(ESPB)on postoperative analgesia for patients undergoing hepatectomy.Methods:75 patients,aged 18-80 years old with ASA Ⅱ ～ Ⅲ,undergoing hepatectomy were randomized into three groups: group D received ESPB with 20 ml of 20μg dexmedetomidine plus 0.375% ropivacaine,group R received ESPB with20 ml of 0.375% ropivacaine,and the control group(group C).US-guided ESPB at right T8 vertebral level was performed at patients in both group D and group R before induction.The indicators included the Visual Analogue Scale(VAS)pain and Ramsay sedation scores at 0-,2-,6-,12-,24-and 48-h after surgery,the time of extubation was defined as 0-h.Besides,mean arterial blood pressure(MAP)and heart rate(HR)at before and 5min after skin incision,the postoperative adverse effects such as nausea and vomiting,the consumption volume of analgesic medicine in patient controlled intravenous analgesia(PCIA),the number of cases requiring rescue analgesia,and the score of postoperative analgesia satisfaction were recorded within 48 hours after operation.Results:The VAS score was lower at 0-,2-and 6-h after surgery in both group D and group R than group C(P<0.05),and the VAS score was lower at 12-and 24-h after surgery in group D than group C(P<0.05),the Ramsay sedation score was higher in both group D and group R than group C at 0-and 12-h after surgery(P < 0.05),the score of postoperative analgesia satisfaction was higher in both group D and group R than group C(P<0.05),but there was no significant difference between group D and group R(P>0.05).Conclusions:US-guided ESPB can effectively relief the early postoperative pain,reduce adverse effects and increase postoperative satisfaction among patients during hepatectomy.Dexmedetomidine as an adjunctive to ESPB can effectively prolong the analgesic time,but it was not proved that dexmedetomidine as an adjunctive to ESPB can effectively enhance the analgesic effect.