Comparative evaluation of perineural dexamethasone withropivacaine and dexamothasone alone in thoracic paravertebral block for postoperative analgesia in elective thoracotomy: A randomized, double-blind, placebo-controlled trial
Keywords:Chronic pain, dexamethasone, nerve block, thoracotomy
Background: Thoracotomy operations generally painful, and poor pain control during the perioperative period can lead to postoperative problems such pneumonia, atelectasis, or respiratory failure. Furthermore, chronic postthoracotomy pain (CPTP), which lasts at least two months following thoracotomy, affects 30%–50% of patients, lowering their quality of life significantly.Because single-dose local anesthetics offer pain reliefof limited duration, adjuvants have been used to provide pro-long analgesia for peripheral nerve block because single-dose local anaesthetics provide only short-term pain relief. Aim: The goal of this study was to see if perineural dexamethasone combined with ropivacaine was effective in treating thoracic paravertebral block (TPVB) in patients undergoing elective thoracotomy. Patients and methods: In this study, 108 patients undergoing thoracotomy were randomised to one of three groups for TPVB adjuvant therapy: group S (saline), group R (0.5 percent ropivacaine), or group RD (0.5 percent ropivacaine) (5 mg dexamethasone and 0.5 percent ropivacaine). Analgesia after surgery, recuperation time, and chronic discomfort were all recorded. Results: In comparison to group S, groups R and RD spent less time in the postanaesthesia care unit, were out of bed earlier, and had shorter postoperative hospital stays. When compared to group S, the RD group regained consciousness sooner, had lower acute pain scores, and utilised less patient-controlled analgesia during the first 72 hours after surgery. 3 months postoperatively, group RD (19.0 percent) had less postthoracotomy pain than group S (47.6 percent), p ≤0.050. Conclusion: With an opioid-based anaesthetic regimen, perineural dexamethasone with ropivacaine for TPVB enhances postoperative analgesia quality, lowers recovery time, and may minimize the incidence of chronic pain after thoracotomy.
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Copyright (c) 2021 Hirday Kumar, Aditya Prakash, Pankaj Kumar
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