Abstract:Objective To observe the analgesic effect of dexmedetomidine combined with ropivacaine intercostal nerve block on patients undergoing thoracoscopic pulmonary wedge resection (TPWR).Methods From September 2021 to September 2023, 120 patients undergoing TPWR at Wuzhou Gongren Hospital were selected prospectively. All patients underwent intercostal nerve block before induction of general anesthesia, and were randomly divided into a control group (n=60, receiving ropivacaine intercostal nerve block) and a study group (n=60, receiving dexmedetomidine + ropivacaine intercostal nerve block). Heart rate (HR) and mean arterial pressure (MAP) were compared between the two groups at T0 (before anesthesia induction), T1 (after intubation), T2 (after skin incision), and T3 (end of surgery). Visual Analog Scale (VAS) scores at 6 h, 12 h, 24 h, and 48 h postoperatively during rest and activity were recorded and compared. Postoperative complications in both groups were also documented. Results There was no statistical difference in HR and MAP between the study group and the control group at T0, T1, T2 and T3 (P＞0.05). Compared with the control group, the VAS scores in the study group were lower at 6 h, 12 h, 24 h and 48 h after operation (P＜0.05). Compared with the control group, the postoperative block disappeared longer in the study group ［(15.75±4.39)h vs (9.00±2.41)h, t=10.345, P＜0.01］, and the total number of PCIA compressions after operation in the study group was less ［(5.30±1.15)times vs (6.95±2.20)times, t=5.149, P＜0.01］. There was no statistical difference in the remedial analgesia rate and postoperative hospital-stay between two groups (P＞0.05). There was no statistically significant difference in the incidence of postoperative complications between the control group and the study group (5.00% vs 1.67%, χ²=1.034, P=0.309). Conclusion Dexmedetomidine combined with ropivacaine for intercostal nerve block in TPWR, which is beneficial to stabilize HR an MAP during operation, prolong the blocking time, and reduce postoperative pain and the total compression times of PCIA.