IV dexamethasone efficacious adjunct to Ultrasound-Guided Paravertebral Block in thoracoscopic surgery

BANGKOK: In a study published in the Journal of Pain Research, intravenous dexamethasone used in conjunction with a single injection of an ultrasound-guided thoracic paravertebral block (USG-TPVB) after video-assisted thoracoscopic surgery increased the duration of analgesia, had an opioid-sparing effect, and improved postoperative pain relief.

When performing video-assisted thoracoscopic surgery, the thoracic paravertebral block (TPVB) is advised regional analgesia. Acute postoperative pain alleviation from a single injection of TPVB is not long-lasting enough. It is technically challenging and frequently unreliable to do continuous TPVB with a catheter. With some peripheral nerve blocks, intravenous dexamethasone prolongs the duration of the analgesic. However, there is little information available on the impact of intravenous dexamethasone on TPVB pain relief.

In this study, individuals who got a thoracic paravertebral block for video-assisted thoracoscopic surgery had their intravenous dexamethasone analgesic efficacy evaluated.

In this multicenter prospective randomized controlled trial, the investigators enrolled patients between the ages of 18 and 80 who underwent elective VATS and had an American Society of Anesthesiologists physical status class of 1 through 3. In total, 59 patients were analyzed. Participants under general anesthesia were given either 8 mg of intravenous dexamethasone (group D) or saline at random (group C). 29 patients were included in group D and 30 patients in group C . The T4-T5 and T6-T7 spaces underwent ultrasound-guided TPVB (USG-TPVB). For both study groups, multimodal analgesia was produced using paracetamol, tramadol, and intravenous morphine. Time for the first analgesic need was the main result. They evaluated postoperative pain using a numeric rating scale (NRS), total morphine intake, and postoperative nausea and vomiting (PONV).