Relative effects of serratus anterior plane block performed with dexmedetomidine combined with ropivacaine or ropivacaine alone on quality of recovery in children undergoing ear reconstruction.

Abstract

Dexmedetomidine (Dex) as a local anesthesia adjuvant for nerve block procedures can improve the quality of patient recovery. However, the impact of using Dex as a local anesthetic adjuvant for serratus anterior plane block (SAPB) procedures on recovery quality for children undergoing ear reconstruction remains unclear. Eighty-four patients who underwent ear reconstruction with autogenous costal cartilage (ACC) were randomized into two groups (n = 42/group) in which SAPB was performed with ropivacaine alone (R group) and with Dex and ropivacaine (DR group). Primary outcomes were patient 15-item quality of recovery (QoR-15) scale scores on days 1 and 2 post-surgery. Secondary outcomes included postoperative rest and coughing numerical rating scale (NRS) chest pain scores, duration of analgesia, oral rescue analgesic usage, and opioid-related side effects. Forty patients per group completed the study. QoR-15 scores on days 1 and 2 post-surgery in the DR group were significantly increased relative to the R group (126.35 ± 9.81 vs. 115.53 ± 8.58 and 131.78 ± 8.67 vs. 122.80 ± 8.59, all P < 0.001). Rest and coughing NRS chest pain scores at 2, 4, 8, 12, and 24 h postoperatively in the DR group were all significantly lower relative to the R group (all P < 0.05). The DR group also exhibited significantly longer analgesic duration (P < 0.001) and significantly reduced incidences of oral rescue analgesic usage and opioid-related side effect (all P < 0.05). Combining Dex and ropivacaine for SAPB in children undergoing ear reconstruction with ACC can significantly improve the quality of recovery, quality of analgesia, and analgesic duration.