# Application and safety analysis of paravertebral block with dezocine and ropivacaine in video-assisted thoracoscopic surgery for lung cancer

## TL;DR

This study compares two doses of dezocine combined with ropivacaine for thoracic paravertebral block in lung cancer surgery, finding different benefits for recovery and pain control.

## Contribution

The study evaluates the safety and efficacy of two dezocine doses in thoracic paravertebral block for VATS lung cancer surgery.

## Key findings

- Higher dezocine doses (0.15 mg/kg) improved postoperative analgesia and reduced inflammation.
- Lower dezocine doses (0.1 mg/kg) led to faster recovery times after surgery.
- Both doses showed similar safety profiles with no significant difference in adverse events.

## Abstract

This study aimed to analyze the application and safety of different doses of dezocine combined with ropivacaine for thoracic paravertebral block (TPVB) in video-assisted thoracoscopic surgery (VATS) for lung cancer.

A total of 192 patients with non-small cell lung cancer undergoing VATS were prospectively enrolled and randomly allocated into two groups using a random number table method: L-dose (0.1 mg⋅kg–1 dezocine + 0.375% ropivacaine for TPVB before general anesthesia induction, n = 96) and H-dose (0.15 mg⋅kg–1 dezocine + 0.375% ropivacaine for TPVB before general anesthesia induction, n = 96). Clinical baseline data, surgical time and recovery-related time (spontaneous breathing recovery, awakening, and extubation), analgesic use within 12 h, pain scores at 1, 6, 12, and 24 h (VAS, resting and active states), serum inflammatory markers [CRP, TNF-α, procalcitonin (PCT)], and adverse events were recorded.

Relative to the H-dose group, the L-dose group showed faster recovery of breathing, awakening, and extubation (all P < 0.001). The H-dose group required fewer analgesic pump uses and rescue analgesia within 12 h (16.67% vs. 46.88%, P < 0.001). VAS scores increased postoperatively, peaked within 12 h, and declined at 24 h; at all time points, scores were lower in the H-dose group (all P < 0.05). Both groups showed transient increases in CRP, TNF-α, and PCT at 24 h, followed by declines after drain removal (all P < 0.01). The overall incidence of adverse events did not differ markedly between the L-dose and H-dose groups (6.25% vs. 8.33%, P > 0.05).

When used in TPVB for VATS, different doses of dezocine combined with ropivacaine offer distinct short-term postoperative benefits: the 0.1 mg⋅kg–1 dezocine results in faster postoperative recovery, whereas the 0.15 mg⋅kg–1 dezocine demonstrates superior postoperative analgesic efficacy and inflammation suppression. Both doses exhibited high safety profiles, providing certain references for the selection of clinical anesthesia protocols.