Effects of Dexmedetomidine Combined with Thoracic Paravertebral Nerve Block on Postoperative Analgesia and Sleep Quality in Patients Undergoing Thoracotomy

doi:10.3969/j.issn.1004-5511.2018.05.011

Abstract：Objective To explore effects of Dexmedetomidine(DEX)combined with thoracic paravertebral nerve block(TPVB)on postoperative anangesia and sleep quality in patients underwent thoracotomy.Methods Sixty pa-tients scheduled for thoracotomy were randomly assigned into TPVB group and TPVB+DEX group with 30 patients in each group.All patients received ultrasound guided TPVB of the operation side and were treated with patient controlled intravenous analgesia(PCIA)after surgery.3 μg/kg of DEX was added to PCIA on the basis of TPVB in TPVB+DEX group.Both resting and coughing visual analogue scales(VAS)and Ramsay sedation scores were recorded at 2 h,4 h, 8 h,24 h and 48 h after surgery.Sufentanil accumulative consumption and incidence of adverse events 48 h after sur-gery were also recorded.The average time of daily sleep and sleep problems index(SPI)were recorded 1 week before and after surgery using medical outcomes study sleep scale(MOS-SS).Subjective sleep quality score was assessed on the night of surgery and one day after surgery.The fatigue status of patients was evaluated using multi-dimensional fatigue inventory-20(MFI-20)1 weeks after surgery.Hospital stay was also recorded after surgery.Results There was no significant difference in resting and coughing VAS between the two groups at all time points(P ＞0.05).The average time of daily sleep was shorter and SPI was higher 1 week after surgery than those before surgery in TPVB group (P ＜0.05).There were no significant differences on average time of daily sleep and SPI 1 week after surgery and be-fore surgery in TPVB+DEX group(P ＞0.05).Compared with TPVB group,the Ramsay sedation scores increased at all time points after surgery,Sufentanil accumulative consumption and incidence of adverse events 48 h after surgery decreased,the average time of daily sleep prolonged and SPI decreased 1 week after surgery,subjective sleep quality score increased on the night of surgery and 1 day after surgery,psychological fatigue,physical fatigue and mental fa-tigue scores decreased 1 week after surgery,hospital stay after surgery shortened in TPVB+DEX group(P ＜0.05). Conclusion DEX combined with TPVB on postoperative anangesia can obtain good analgesic effect,improve sleep quality,alleviate postoperative fatigue and promote rapid rehabilitation after surgery.