Effect Of Diprospan Added To Ropivacaine For Thoracic Paravertebral Nerve Block On Postoperative Analgesia Undergoing Thoracoscopic Surgery

Objective:To observe the effect and adverse reactions of ultrasound-guided injection of ropivacaine and diprospan mixture in the thoracic paravertebral nerve block for multimodal analgesia after video-assisted thoracic surgery.Methods:Patients undergoing video-assisted thoracic surgery under general anesthesia were enrolled in this study and randomly divided into three groups,a control group(Group C),a ropivacaine group(Group R),and a ropivacaine + diprospan group(Group RD).No nerve block was performed in Group C.Ultrasound-guided TPVB was given after anesthesia induction in Group R and Group RD.Group R received 20 m L of 0.375% ropivacaine;Group RD received 20 m L of 0.375% ropivacaine +0.5m L of 3.5mg diprospan mixture;.The primary Primary outcome was the cumulative consumption through patient-controlled analgesia(PCIA)within 48 hours after surgery.Results:1.The dose of remifentanil in group R(11.67 ± 4.49)ug/kg and group RD(11.72 ± 6.78)ug/kg was significantly lower than that in Group C(17.28 ± 7.02)ug/kg.2.The trend of blood pressure decrease in group R and group RD was significantly higher than that in Group C after TPVB 20 minutes,The incidence of hypotension in Group R and RD(31.4% vs 33.3%)was significantly higher than that in Group C(6.25%).3.The VAS scores at rest and during exercise at 6,12,24 and 48 h after surgery were significantly different,R > RD > C.4.The total dosage of PCIA in Group C(81.53 ± 8.35)ml > Group R(62.89 ±4.29)ml > Group RD(57.81 ± 4.15)ml within 48 hours after operation.5.The incidence of postoperative adverse reactions such as dizziness,nausea,vomiting,pruritus,urinary retention,hyperglycemia and wound infection in Group R(11.43%)and group RD(8.33%)was significantly lower than that in Group C(36.67%).6.The time of getting out of bed and taking food for the first time in Group R(24.79 ± 5.57 vs 8.03 ± 2.04)h and Group RD(23.31 ± 4.92 vs 8.76 ± 3.41)h were significantly earlier than in Group C(30.07 ± 6.34 vs 10.84 ± 4.76)h,the difference was statistically significant.Conclusion:Compared with group R for thoracic paravertebral nerve block,patients in the group RD had lower VAS scores and less PCIA consumption within 48 hours after surgery,the first PCA time was later and the analgesic effect was better.