Effect of different doses of dexmedetomidine combined with ropivacaine on anesthesia,perioperative stress,and sleep quality in patients undergoing thoracoscopic lung surgery
Objective To explore the analgesic effect,postoperative stress response,inflammatory response,and sleep quality of thoracic paravertebral nerve block with different doses of dexmedetomidine combined with ropivacaine in patients undergoing thoracoscopic lung surgery.Methods A total of 98 patients with American Society of Anesthesiologists(ASA)grades of Ⅰ-Ⅲundergoing thoracoscopic lung surgery in our hospital from March 2022 to January 2023 were selected.According to the treatment methods,they were divided into the study group(n=43)and the control group(n=55).All the patients in both groups received general anesthesia induction followed by thoracic paravertebral nerve block.Meanwhile,the patients in the the study one received low-dose dexmedetomidine(0.5 μg·kg-1)combined with 0.375%ropivacaine and those in the control received high-dose dexmedetomidine(1.0 μg·kg-1)combined with 0.375%ropivacaine.Visual Analog Scale(VAS)was used to evaluate the degree of postoperative pain.ELISA method was used to measure plasma Interleukin 6(IL-6)and C-reactive protein(CRP)concentrations at different time points before and after surgery.The sleep quality was evaluated using the Pittsburgh Sleep Quality Index(PSQI).The occurrence of adverse reactions was recorded.Results One hour after the operation,there was no difference in VAS scores between the 2 groups(P>0.05).From the 6th to 48th h after surgery,the VAS scores of the two groups were higher than those at 1 hour after operation(P<0.05),and the VAS scores of the study group at 12 h,24 h,and 48 h after operation were higher than those of the control group(P<0.05).The postoperative IL-6 and CRP levels increased compared to preoperative levels in both groups(P<0.05),and the differences between the two groups before and after operation were both significant(P>0.05).The PSQI scores of both groups increased after operation as compared with those before(P<0.05),but there was no statistically significant difference between the 2 groups(P>0.05).The overall incidence of postoperative complications in the study group(2.3%,1/43)was lower than that in the control(16.4%,9/55)(P<0.05).Conclusion High dose dexmedetomidine combined with ropivacaine can better control postoperative pain.However,the low-dose dexmedetomidine combined with ropivacaine has less impact on surgical stress and inflammatory response,and the incidence of postoperative complications is low.
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