SO SÁNH HIỆU QUẢ GIẢM ĐAU SAU PHẪU THUẬT NỘI SOI CẮT THÙY PHỔI CỦA BUPIVACAIN PHỐI HỢP DEXAMETHASON SO VỚI BUPIVACIN ĐƠN THUẦN TRONG GÂY TÊ CƠ DỰNG SỐNG DƯỚI HƯỚNG DẪN SIÊU ÂM

Abstract

Objective: To compare the effect of 0,25% bupivacaine alone versus 0,25% bupivacaine combined with 4mg dexamethasone in ultrasound-guided erector spinae plane block in video-assisted thoracoscopic surgery (VATS) lobectomy. Methods: RCT study, Erector spinae plane block was performed for postoperative analgesia in 70 patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy, divided into two groups: Group I received 30ml of 0,25% bupivacaine, and Group II received 30ml of 0,25% bupivacaine combined with 4mg dexamethasone. Pain relief efficacy was evaluated using VAS pain scores at rest/movement, and morphine consumption. Results: Mean VAS scores at rest/movement in Group II were significantly lower than Group I from 12 to 20 hours post-ESP anesthesia (p < 0,05). Time to first morphine requirement was shorter in Group I compared to Group II: 10,21 ± 1,17 vs 14,44 ± 2,01 hours (p < 0,01). Total morphine consumption at 24 and 48 hours was higher in Group I than Group II: 21,54 ± 4,02 mg/ 36,67 ± 4,14 mg so với 13,26 ± 2,64 mg/22,36 ± 5,62 mg; p < 0,01. Conclusion: Bupivacaine-dexamethasone ESP block demonstrates enhanced pain control versus bupivacaine alone in video-assisted thoracoscopic lobectomy.