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已发表论文
胸腔镜引导下胸椎旁阻滞中静脉注射与椎旁注射地塞米松联合罗哌卡因对胸腔镜肺叶切除术后镇痛效果的比较：一项前瞻性随机对照试验
Authors Wu KW , Deng SY , Zhang XF , Zheng DW, Hu LH
Received 17 May 2025
Accepted for publication 18 September 2025
Published 22 September 2025 Volume 2025:19 Pages 8601—8611
DOI https://doi.org/10.2147/DDDT.S532934
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Georgios Panos
Ke-Wei Wu,1 Shu-Yu Deng,1 Xu-Feng Zhang,1 Da-Wei Zheng,2 Li-Hong Hu1
1Department of Anesthesiology, The Affiliated LiHuiLi Hospital of Ningbo University, Ningbo, People’s Republic of China; 2Department of Thoracic Surgery, The Affiliated LiHuiLi Hospital of Ningbo University, Ningbo, People’s Republic of China
Correspondence: Li-Hong Hu, Department of Anesthesiology, The Affiliated LiHuiLi Hospital of Ningbo University, No. 57 Xingning Road, Ningbo, Zhejiang, 315500, People’s Republic of China, Email hlh_2000@163.com
Background: As an adjuvant, dexamethasone can enhance the analgesic intensity and prolong the duration of nerve blocks. However, to date, no studies have compared the effectiveness of different administration routes of dexamethasone for thoracoscopy-guided thoracic paravertebral block (TTPB). This prospective randomized controlled study evaluated the postoperative analgesic effects of dexamethasone administered intravenously or perineurally in combination with ropivacaine for TTPB in patients undergoing radical lung cancer resection.
Methods: A total of 150 patients were randomly assigned to receive dexamethasone intravenously (Group I, n=75) or perineurally (Group D, n=75). Before wound closure, patients in Group I underwent TTPB with ropivacaine while receiving an intravenous dexamethasone injection, whereas patients in Group D received a perineural mixture of ropivacaine and dexamethasone. The primary outcome was the time to first postoperative rescue analgesia. Secondary outcomes included Visual Analogue Scale (VAS) scores, postoperative 48-hour sufentanil consumption in patient-controlled intravenous analgesia (PCIA), postoperative blood glucose levels, postoperative recovery parameters, and incidence of adverse events.
Results: Compared with Group I, Group D showed a significantly longer time to first postoperative rescue analgesia, lower VAS scores at all assessed time points, and reduced postoperative 48-hour sufentanil consumption. Group D also showed a smaller increase in postoperative blood glucose levels, an earlier time to first ambulation and a shorter postoperative hospital stay (all P < 0.05). However, the incidence of postoperative nausea was higher in Group D than in Group I (P < 0.05).
Conclusion: In TTPB, perineural dexamethasone administration with ropivacaine provided superior and longer-lasting analgesia compared with intravenous administration. Additionally, it accelerated postoperative recovery and shortened hospital stay.
Keywords: dexamethasone, ropivacaine, postoperative analgesia, paravertebral block
1Department of Anesthesiology, The Affiliated LiHuiLi Hospital of Ningbo University, Ningbo, People’s Republic of China; 2Department of Thoracic Surgery, The Affiliated LiHuiLi Hospital of Ningbo University, Ningbo, People’s Republic of China
Correspondence: Li-Hong Hu, Department of Anesthesiology, The Affiliated LiHuiLi Hospital of Ningbo University, No. 57 Xingning Road, Ningbo, Zhejiang, 315500, People’s Republic of China, Email hlh_2000@163.com
Background: As an adjuvant, dexamethasone can enhance the analgesic intensity and prolong the duration of nerve blocks. However, to date, no studies have compared the effectiveness of different administration routes of dexamethasone for thoracoscopy-guided thoracic paravertebral block (TTPB). This prospective randomized controlled study evaluated the postoperative analgesic effects of dexamethasone administered intravenously or perineurally in combination with ropivacaine for TTPB in patients undergoing radical lung cancer resection.
Methods: A total of 150 patients were randomly assigned to receive dexamethasone intravenously (Group I, n=75) or perineurally (Group D, n=75). Before wound closure, patients in Group I underwent TTPB with ropivacaine while receiving an intravenous dexamethasone injection, whereas patients in Group D received a perineural mixture of ropivacaine and dexamethasone. The primary outcome was the time to first postoperative rescue analgesia. Secondary outcomes included Visual Analogue Scale (VAS) scores, postoperative 48-hour sufentanil consumption in patient-controlled intravenous analgesia (PCIA), postoperative blood glucose levels, postoperative recovery parameters, and incidence of adverse events.
Results: Compared with Group I, Group D showed a significantly longer time to first postoperative rescue analgesia, lower VAS scores at all assessed time points, and reduced postoperative 48-hour sufentanil consumption. Group D also showed a smaller increase in postoperative blood glucose levels, an earlier time to first ambulation and a shorter postoperative hospital stay (all P < 0.05). However, the incidence of postoperative nausea was higher in Group D than in Group I (P < 0.05).
Conclusion: In TTPB, perineural dexamethasone administration with ropivacaine provided superior and longer-lasting analgesia compared with intravenous administration. Additionally, it accelerated postoperative recovery and shortened hospital stay.
Keywords: dexamethasone, ropivacaine, postoperative analgesia, paravertebral block