Work

Safety and efficacy of dexmedetomidine in combination with ropivacaine for lumbar paravertebral block in posterior lumbar surgery: a randomized controlled trial

Year: 2026

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: OBJECTIVE: To evaluate the analgesic synergistic effect of ropivacaine lumbar paravertebral block (LPB) on patients undergoing lumbar surgery under general anesthesia, and to investigate whether dexmedetomidine as a local anesthetic adjuvant can further enhance analgesic efficacy, suppress perioperative stress-induced inflammatory responses, and improve postoperative recovery quality. METHODS: A total of 120 patients scheduled for elective posterior lumbar surgery were enrolled and randomly assigned to three groups (n = 40 each) using a random number table. All patients underwent general anesthesia. Prior to anesthesia induction, the L group and DL group received ultrasound-guided bilateral lumbar paracentesis (LPB). The L group received 15 mL of 0.375% ropivacaine per side, while the DL group received 15 mL of 0.375% ropivacaine containing 0.5 µg/kg dexmedetomidine per side. The C group did not receive nerve block. The primary outcome measure was intraoperative sufentanil dosage, while secondary outcomes included postoperative numeric rating scale (NRS) scores for rest and activity, 15-item quality of recovery (QoR-15) scores, serum levels of inflammatory and stress markers, and the incidence of perioperative adverse events. RESULTS: Overall significant differences in intraoperative propofol and sufentanil doses were observed among the three groups (all adjusted P < 0.05). Post-hoc pairwise comparisons showed that Group L and Group DL had significantly lower intraoperative propofol and sufentanil doses compared with Group C (all Bonferroni-adjusted P < 0.0167). Furthermore, the doses of both agents were significantly lower in Group DL than in Group L (all Bonferroni-adjusted P < 0.0167). Compared with Group C, Groups L and DL demonstrated significantly reduced intraoperative sufentanil dosage, markedly lower NRS scores at all postoperative time points, significantly higher QoR-15 scale scores, and significantly lower serum levels of inflammatory and stress markers (all P < 0.05 after adjustment). All these outcomes in Group DL showed significant improvement compared to Group L (all P < 0.05 after adjustment). No statistically significant differences were observed in perioperative adverse event rates among the three groups (P > 0.05). CONCLUSION: Lopivacaine LPB effectively optimizes perioperative management for patients undergoing lumbar surgery. The addition of dexmedetomidine as an adjuvant further enhances analgesic efficacy, prolongs analgesia duration, suppresses perioperative stress-induced inflammatory responses, significantly improves early postoperative recovery quality, and demonstrates favorable short-term safety.

Source: BMC Anesthesiology

DOI: 10.1186/s12871-026-03782-3