Data used in analysis.

BackgroundLocal anaesthetic adjuvants have been shown to provide better pain relief and extend the duration of analgesia. But little information is available on which adjuvants are more effective in block extension for thoracic paravertebral block (TPVB) during video-assisted thoracoscopic surgery (VATS). This study aimed to compare the analgesic efficacies of different adjuvants with 0.375% ropivacaine in ultrasound-guided TPVB for VATS.MethodsA total of 120 patients who underwent VATS at the study hospital in 2022–2023 were recruited and randomly divided into four groups, including the control group (Group R), which received 20 ml ropivacaine 0.375% for TPVB, and the intervention groups: Group D (0.375% ropivacaine with 1 µg/kg dexmedetomidine in a total of 20 ml for TPVB), group E (0.375% ropivacaine with 0.1 mg/kg dexamethasone in a total of 20 ml for TPVB), and group S (0.375% ropivacaine with 0.5ug/ml sufentanil in a total of 20 ml for TPVB). They received a single-injection ultrasound-guided unilateral T5-level TPVB. The primary clinical outcomes were visual analogue scale (VAS) pain scores at rest and during coughing at 4, 8, 12, 16, 20, 24, and 48 h postoperatively. Secondary outcomes included opioid consumption, number of patient-controlled intravenous analgesics (PCIA) used within 48 h, postoperative rescue analgesia, side effects, quality of recovery after surgery, and length of hospital stay.ResultsWe found that the VAS pain scores in the resting state during the postoperative period at 12–20 h were lower in Group D than in Group R (P P ConclusionsThese findings suggest that adjuvant analgesia for TPVB can improve postoperative pain in patients undergoing VATS. However, compared with dexamethasone and sufentanil, dexmedetomidine is more effective in extending the duration of analgesia, reducing the demand of postoperative analgesics, improving the quality of recovery at 48 h postoperatively and shorting the length of hospital stay.