Effects of Dexmedetomidine Used in Continuous Thoracic Paravertebral Blocks
Condition: Post-thoracotomy Pain Syndrome
MeSH terms: Syndrome
Study type: Interventional
Phase: Phase 4

Summary: 
      The purpose of this study is to explore the effectiveness of dexmedetomidine as an adjunctive
      analgesic, used in ultrasound-guided continuous thoracic paravertebral blocks for
      Post-thoracotomy Pain Syndrome(PTPS).
    

Detailed description: 
      Thoracic surgical procedures are among the most painful operations, and their outcomes are
      affected adversely by postoperative discomfort. Post-thoracotomy pain syndrome (PTPS) is a
      well-recognized complication of thoracotomy. Post-thoracotomy pain control improves patient
      satisfaction and decreases postoperative complication morbidity. Epidural analgesia used to
      be considered as the best method of pain relief after major surgery despite its side-effects,
      which includes hypotension, respiratory depression, incomplete or failed block, etc.
      Recently, paravertebral block is an alternative technique that may offer a comparable
      analgesic effect and a better side-effect profile for post-thoracotomy pain.
      Dexmedetomidine(DEX) is a Food and Drug Administration-approved, parenteral, selective
      α2-agonist that induces anxiolytic and analgesia without respiratory depression. It could
      provide dose-dependent sedation , analgesia , anti-anxiety and inhibition of sympathetic
      nerves and other effects . Current studies with regard to the effectiveness of DEX as an
      adjunctive medicine, used in ultrasound-guided continuous thoracic paravertebral blocks for
      PTPS. The mechanical withdrawal threshold and VAS scores are recorded. The consumption of
      opioid and general anesthetics during perioperative period are also recorded. To compare the
      incidence rates of side effects, such as nausea, vomiting, dizziness, hypotension and
      bradyarrhythmia in the first 3 days after operation among the groups.Also,to measure and
      compare the level of inflammatory factor in different group.A questionnaire is adopted to
      investigate whether there are chronic pain symptoms happen at 6 months after the operation
      which aim to PTPS.
    

Intervention name(s): Dexmedetomidine; Ropivacaine; Mindray M7 series
Intervention type(s): Drug; Drug; Device
Intervention description(s): Group GTD received thoracic continuous paravertebral nerve block with dexmedetomidine (0.5μg/kg) added to ropivacaine before anesthesia induction, and used continuous thoracic paravertebral nerve block patient-controlled analgesia(with dexmedetomidine 100μg）.; Group GE\GT\GTD respectively received continuous nerve blocks and postoperative analgesia combined with ropivacaine.; Ultrasound real-time guidance have been used in continuous thoracic paravertebral blocks in group GT and group GTD.
Intervention MeSH terms: Dexmedetomidine; Ropivacaine
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Paravertebral Blocks; Dexmedetomidine; Analgesia; Inflammatory response; Thoracotomy