Ropivacaine for thoracoscopy-guided thoracic paravertebral block (TTPB) offers only a short duration of postoperative pain relief, which is inadequate for managing pain following thoracic surgery. Research has shown that combining dexamethasone with ropivacaine significantly prolongs the duration of analgesia from the nerve block. We hypothesised that TTPB with ropivacaine combined with dexamethasone would enhance postoperative analgesia and prolong the duration of analgesia in patients undergoing radical thoracoscopic lung cancer surgery. The study randomly assigned patients to either a control group (Group C, n = 40) or a dexamethasone group (Group D, n = 40). TTPB injection of ropivacaine or ropivacaine combined with dexamethasone prior to surgical sutures. The study compared postoperative pain satisfaction scores、48 h postoperative rescue analgesia frequency、visual analogue scale (VAS) scores, the 24-h patient-controlled analgesia (PCIA) sufentanil consumption, blood glucose levels, adverse events and recovery status. Group D demonstrated higher postoperative pain satisfaction scores and lower 48 h postoperative rescue analgesia frequency compared to Group C. Additionally, Group D had significantly lower VAS scores at 6, 12, 24, and 48 h post-operation, as well as a reduced 24-h PCIA sufentanil consumption, shorter time to first mobilization, and shorter hospital stay compared to Group C (all P <
0.05). The VAS scores at 2 h postoperatively were significantly lower in Group D compared to scores at 24 and 48 h postoperatively. Conversely, Group C showed significantly lower VAS scores at 2 h postoperatively compared to scores at 6, 12, 24, and 48 h postoperatively. The addition of dexamethasone as an adjuvant to ropivacaine enhanced the analgesic efficacy of TTPB, prolonged the duration of pain relief, and reduced the time to first ambulation and hospital stay duration.Trial Registry: ChiCTR (2400086347)
Registered 28/06/2024.