Nalbuphine and dexmedetomidine as adjuvants to ropivacaine in ultrasound-guided erector spinae plane block for video-assisted thoracoscopic lobectomy surgery

Abstract

Background:Adjuvants to local anesthetics, such as nalbuphine and dexmedetomidine, can be used to improve the quality and duration of peripheral nerve block effects. Dexmedetomidine has been successfully used as an adjuvant of erector spinae plane block (ESPB) with ropivacaine in video-assisted thoracoscopic lobectomy surgeries (VATLS). This study aimed to compare the effects of nalbuphine and dexmedetomidine used as adjuvants to ropivacaine for ESPB in VATLS.Methods:A total of 102 patients undergoing VATLS with ESPB were enrolled and randomized into 3 groups, each of which received a different adjuvant to ropivacaine. The visual analogue scale score, onset and duration of sensory block, use of patient-controlled analgesia (PCA), rate of rescue analgesia, duration of postoperative hospitalization, incidence of postoperative nausea and vomiting, and chronic pain were measured and observed.Results:The visual analogue scale score, total PCA use, rate of rescue analgesia, and postoperative chronic pain in the ropivacaine with dexmedetomidine (RD), and ropivacaine with nalbuphine (RN) groups were lower than those in the ropivacaine (RC) group (P < .05). The duration of sensory block was longer and the first use of PCA occurred later in the RD and RN groups than they did in the RC group (P < .05).Conclusions:As an adjuvant to ropivacaine in ESPB, nalbuphine and dexmedetomidine are comparable in terms of the associated analgesia, sensory block duration, need for rescue analgesia, and incidence of chronic pain in patients after VATLS.

Impact of Ultrasound-Guided Deep Serratus Anterior Plane Block Combined With Dexmedetomidine as an Adjuvant to Ropivacaine Inpatient Quality of Recovery Scores Undergoing Modified Radical Mastectomy: A Randomized Controlled Trial

“…However, the time of using ropivacaine alone for a nerve block is short and the postoperative analgesic effect is limited. Dexmedetomidine combined with ropivacaine can enhance peripheral nerve block and prolong sensory block time ( 45 , 46 ). Our present study showed that ropivacaine plus dexmedetomidine (μg/kg−1) had better analgesic efficacy than ropivacaine alone.…”

Effect of Ultrasound-Guided Fascia Iliac Compartment Block with Nalbuphine and Ropivacaine on Preoperative Pain in Older Patients with Hip Fractures: A Multicenter, Triple-Blinded, Randomized, Controlled Trial

“…Rao et al. found that nalbuphine or dexmedetomidine as an adjuvant to ropivacaine in ultrasound guided erector spine plane block provided comparable pain control and prolonged sensory block duration in video-assisted thoracoscopic lobectomy surgery [ 32 ]. Consistent with previous studies, we found that the addition of nalbuphine prolonged the duration of analgesia and increased the sensory block area compared with ropivacaine alone.…”

The effect and safety of dexmedetomidine as an adjuvant to local anesthetics in erector spinae plane block: a systematic review and meta-analysis of randomized controlled trials

“…When data were not presented in the original literature, we contacted the author to obtain the required information. Last resort, when means and SDs values were not available (the time rst to request rescue analgesia [19][20][21][22], number of PCIA presses [19,21,22]), these values were imputed using the calculation methods of two statistical experts McGrath [14] and Cai [15]. Data from trial [22] with two intervention groups receiving different doses of DEX were combined into a single group as per the Cochrane Handbook [16].…”

“…Finally, 8 RCTs were included in the study [19][20][21][22][23][24][25][26]. Fig 1 represents the preferred reporting items for systematic reviews and meta-analysis (PRISMA) ow diagram, and summarizes the reasons for exclusion of records [13].…”