{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T06:18:28Z","timestamp":1778998708335,"version":"3.51.4"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T00:00:00Z","timestamp":1746144000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Cuiying Project of Lanzhou University Second Hospital .","award":["CY2021-BJ-A12"],"award-info":[{"award-number":["CY2021-BJ-A12"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Local 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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A total of 120 patients who underwent VATS at the study hospital in 2022\u20132023 were recruited and randomly divided into four groups, including the control group (Group R), which received 20\u2009ml ropivacaine 0.375% for TPVB, and the intervention groups: Group D (0.375% ropivacaine with 1 \u00b5g\/kg dexmedetomidine in a total of 20\u2009ml for TPVB), group E (0.375% ropivacaine with 0.1\u2009mg\/kg dexamethasone in a total of 20\u2009ml for TPVB), and group S (0.375% ropivacaine with 0.5ug\/ml sufentanil in a total of 20\u2009ml 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\u2009h postoperatively. Secondary outcomes included opioid consumption, number of patient-controlled intravenous analgesics (PCIA) used within 48\u2009h, postoperative rescue analgesia, side effects, quality of recovery after surgery, and length of hospital stay.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>We found that the VAS pain scores in the resting state during the postoperative period at 12\u201320\u2009h were lower in Group D than in Group R (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). The resting VAS pain scores of Groups E and S were lower than those of Group R during the postoperative period of 12\u201316\u2009h (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Similar differences were observed in the pain scores during coughing at the same time points. Additionally, the co-administration of adjuvants with ropivacaine were associated with decreased consumption of postoperative opioids, less frequent PCIA use, and earlier time to ambulation. The intergroup pairwise comparisons showed that dexmedetomidine was more effective than dexamethasone and sufentanil in reducing additional postoperative analgesics, the length of chest tube placement and length of hospital stay. Subsequently, we administered questionnaires on the quality of recovery, which was positively correlated with the postoperative analgesic effect.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>These 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\u2009h postoperatively and shorting the length of hospital stay.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0322589","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T17:41:46Z","timestamp":1746207706000},"page":"e0322589","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Comparison of different adjuvant analgesia for paravertebral block in video-assisted thoracoscopic surgery: A double-blind randomized controlled trial"],"prefix":"10.1371","volume":"20","author":[{"given":"Rong","family":"Tang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-sheng","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hai-lian","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fang","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3020-9549","authenticated-orcid":true,"given":"Yu-qian","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,5,2]]},"reference":[{"issue":"2","key":"pone.0322589.ref001","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1097\/ALN.0000000000000747","article-title":"Different Approaches to Ultrasound-guided Thoracic Paravertebral Block: An Illustrated Review","volume":"123","author":"A.C. 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Kamel","year":"2022","journal-title":"Pain Physician"},{"issue":"34","key":"pone.0322589.ref003","doi-asserted-by":"crossref","first-page":"3406","DOI":"10.1111\/1759-7714.15135","article-title":"Effect of ultrasound-guided thoracic paravertebral block on perioperative analgesia in elderly patients undergoing video-assisted thoracic lobectomy in China: An interventional clinical randomized controlled trial","volume":"14","author":"C Gong","year":"2023","journal-title":"Thorac Cancer"},{"issue":"6","key":"pone.0322589.ref004","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1093\/bja\/aei250","article-title":"Single-injection thoracic paravertebral block for postoperative pain treatment after thoracoscopic surgery","volume":"95","author":"A Vogt","year":"2005","journal-title":"Br J Anaesth"},{"key":"pone.0322589.ref005","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jclinane.2016.10.038","article-title":"Anesthesia management with ultrasound-guided thoracic paravertebral block for donor nephrectomy: A prospective randomized study","volume":"37","author":"O Yenid\u00fcnya","year":"2017","journal-title":"J Clin Anesth"},{"issue":"1","key":"pone.0322589.ref006","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/AJP.0000000000000992","article-title":"Dexmedetomidine Added to Ropivacaine for Ultrasound-guided Erector Spinae Plane Block Prolongs Analgesia Duration and Reduces Perioperative Opioid Consumption After Thoracotomy: A Randomized, Controlled Clinical Study","volume":"38","author":"Q Wang","year":"2021","journal-title":"Clin J Pain"},{"issue":"1","key":"pone.0322589.ref007","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1186\/s12871-023-02231-9","article-title":"Effect of erector spinae plane block with different doses of dexmedetomidine as adjuvant for ropivacaine on the postoperative quality of recovery after video-assisted thoracoscopic lobectomy surgery: a randomized controlled trial","volume":"23","author":"Y Guo","year":"2023","journal-title":"BMC Anesthesiol"},{"issue":"3","key":"pone.0322589.ref008","doi-asserted-by":"crossref","first-page":"e117146","DOI":"10.5812\/aapm.117146","article-title":"Adjuvant Drugs for Peripheral Nerve Blocks: The Role of NMDA Antagonists, Neostigmine, Epinephrine, and Sodium Bicarbonate","volume":"11","author":"AN Edinoff","year":"2021","journal-title":"Anesth Pain Med"},{"issue":"3","key":"pone.0322589.ref009","doi-asserted-by":"crossref","first-page":"e103141","DOI":"10.5812\/aapm.103141","article-title":"Efficacy of Serratus Anterior Plane Block Using Bupivacaine\/ Magnesium Sulfate Versus Bupivacaine\/ Nalbuphine for Mastectomy: A Randomized, Double-Blinded Comparative Study","volume":"10","author":"D. 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