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

Objective 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. Methods 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. Results 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). Conclusion 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.