Effect of thoracic paravertebral block with ropivacaine and compound betamethasone on postoperative pain after thoracoscopic surgery: A randomized, double-blind, controlled trial.

BACKGROUND

The purpose was to evaluate the effect of thoracic paravertebral block (TPVB) with a combination of ropivacaine and compound betamethasone on postoperative pain in patients undergoing thoracoscopic surgery.

METHODS

A randomized, double-blind, controlled trial was conducted. A total of 100 patients undergoing elective thoracoscopic pulmonary lesion resection were randomly divided into 2 groups: the ropivacaine group (group R) and the ropivacaine combined with compound betamethasone group (group RD). The pain intensity at rest/coughing was assessed by the Visual Analogue Scale (VAS) at different times. The incidence of pain (VAS ≥ 1) at 1-, 3-, and 6-month follow-up was recorded. The anesthetic dosage, adverse effects, and postoperative recovery parameters were also observed.

RESULTS

Compared to group R, group RD demonstrated a significant reduction in additional patient-controlled intravenous analgesia pump presses at 24 hours postoperatively and significantly lower VAS scores at rest/coughing after extubation, and at 6, 12, 24, 48, 72 hours, and 1-month postoperatively (P <.05). Group RD reduced the incidence of pain at 1, 3, and 6 months postoperatively more than group R (P <.05), as well as in postoperative nausea, vomiting, and drowsiness. No statistically significant differences were observed between the 2 groups regarding postoperative blood glucose levels, duration of drainage tube placement, time to first mobilization, and length of hospital stay.

CONCLUSION

These results suggest that the combination of ropivacaine and compound betamethasone in TPVB effectively reduces both acute and chronic postoperative pain after thoracoscopic surgery. It also decreases the incidence of postoperative adverse reactions, making it a superior adjuvant for TPVB with local anesthetics.