Comparison of dexmedetomidine or sufentanil combined with ropivacaine for epidural analgesia after thoracotomy: a randomized controlled study

摘要

Background: Thoracotomy is frequently accompanied with moderate-to-severe postoperative pain, and excellent pain management is important for early rehabilitation. The purpose of this study is to investigate the effects of dexmedetomidine combined with ropivacaine for epidural analgesia after thoracotomy. Methods: One hundred and thirty patients undergoing elective lung lobectomy were enrolled in the double-blind study and randomly divided into two groups. Group A received 0.5 μg/mL of dexmedetomidine plus 0.1% ropivacaine for postoperative analgesia, and group B (control group) received 0.5 μg/mL of sufentanil plus 0.1% ropivacaine for postoperative analgesia. Hemodynamic parameters were monitored. Pain intensity at rest was assessed using a visual analog scale (VAS) at 2, 4, 6，8, 12, 24, and 48 hrs postoperatively. Ramsay sedation score (RSS), analgesic consumption, postoperative respiratory depression, nausea and vomiting, pruritus, and bradycardia were recorded. Results: The VAS values at rest during the postoperative 6–48 hrs were lower in group A than those in group B ( P 0.05), and the RSS values were higher in group A during the postoperative 4–48 hrs compared to group B ( P 0.05). Side effects were similar between the groups ( P 0.05). Conclusion: Dexmedetomidine combined with ropivacaine may provide better postoperative analgesia and sedative effect in patients undergoing thoracic surgery with fewer side effects. It is superior to sufentanil in analgesic effect during postoperative analgesia after thoracotomy.