Efficacy of dexmedetomidine mixed with ropivacaine for transversus abdominis plane block (TAPB) combined with general anesthesia in patients undergoing laparoscopic colorectal surgery
10.3760/cma.j.issn.1008-1372.2019.05.019
- VernacularTitle:右美托咪啶混合罗哌卡因行腹横肌平面阻滞在经腔镜结直肠癌根治术全麻镇痛中的应用
- Author:
Lei LYU
1
;
Leilei CHEN
;
Juping HE
Author Information
1. 浙江省东阳市人民医院
- Keywords:
Dexmedetomidine;
Ropivacaine;
Nerve block;
Colorectal neoplasms;
Laparoscopy;
Analgesia
- From:
Journal of Chinese Physician
2019;21(5):719-722,726
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy of dexmedetomidine (DEX) mixed with ropivacaine for transversus abdominis plane block (TAPB) combined with general anesthesia in the patients undergoing laparoscopic colorectal surgery.Methods 58 patients scheduled for laparoscopic colorectal surgery under general anesthesia were randomly divided into 3 groups using a random number table:general anesthesia group (group A n =19),ropivacaine for TAPB group (group B n =20),and Dex mixed ropivacaine for TAPB group(group C n =19).After the end of anesthesia induction,ultrasound-guided bilateral TAPB was performed in B and C groups.20 ml of 0.25％ ropivacaine and 0.5 μg/kg DEX mixed with 0.25％ ropivacaine were injected into each side in groups B and C respectively.Patient controlled intravenous analgesia (PCIA) with sufentanil 100 μg and tropisetron 5 mg in 100 ml of normal saline was provided to all patients after surgery.When the visual analogue scale (VAS) score ≥ 4,tramadol 50-100 mg was intravenously injected as remedial analgesic.VAS scores were measured respectively after extubation and 6,12,24 h after surgery.The consumption of remifentanil during the operation and sufentanil during PCIA,and the number of successfully delivered doses and patients requiring rescue analgesic were recorded within 24 hrs after surgery.The occurrence of TAPB-related adverse events were also recorded.Results Compared with group A,the consumption of reminfentanil during the operation and sufentanil during PCIA,and the amount of successfully delivered doses and patients requiring rescue analgsia within 24hrs after surgery,were decreased in B and C groups (P ＜ 0.05).Furthermore,those numbers in group C are more less than group B in 12-24 hrs after the surgery.There were no significant difference among the three groups in the incidence of adverse reactions (P ＞0.05).TAPB-related complication were not found in B and C groups.Conclusions 0.5 μg/kg DEX mixed with 0.25％ ropivacaine for TAPB combined with general anesthesia can play a better analgesic effect in the patiens urdergoing laparoscopic colorectal surgery.
