Postoperative analgesic effects of Dexmedetomidine plus Ropivacaine for abdominal fascia block in elderly patients following colon cancer surgery
10.3760/cma.j.issn.0254-9026.2020.06.015
- VernacularTitle:右美托咪定复合罗哌卡因腹部筋膜阻滞对老年患者结肠癌术后镇痛效果的影响
- Author:
Tao CHEN
1
;
Jianlong DU
;
Jianliang SUN
Author Information
1. 浙江大学医学院附属杭州市第一人民医院麻醉科，杭州 310006；浙江省桐乡市第一人民医院麻醉科，嘉兴 314500
- From:
Chinese Journal of Geriatrics
2020;39(6):672-675
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the analgesic effects of Dexmedetomidine combined with Ropivacaine for abdominal fascia block(AFB, with transverse abdominis plane block and rectus abdominis sheath block)in elderly patients undergone open surgery for colon cancer.Methods:This was a prospective study.Fifty elderly patients following ASA Ⅰ-Ⅲ open surgery for colon cancer were randomly divided into Group R and Group RD.Patients in Group R were treated with Ropivacaine for AFB, and those in Group RD were given Dexmedetomidine 0.5 μg/kg and Ropivacaine.All patients received Morphine-based patient-controlled intravenous analgesia(PCIA)after surgery.The total dose of postoperative Morphine, the time to first required use of Morphine, and the visual analog score(VAS)at 4, 8, 16, and 24 h after surgery were compared between the two groups.Results:Compared with Group R, patients in Group RD were associated with a significantly decreased total amount of Morphine at 24 h after surgery [25(20-32)mg vs.30(22-38)mg, Z=5.00, P<0.001], a lower VAS at 4 h [17(15-19) vs.36(23-39), Z=23.04, P<0.001]and 8 h after surgery [20(18-22) vs.41(38-55), Z=25.47, P<0.001], a longer time to first required use of Morphine [233(204-256)min vs.183(167-195)min, Z=4.367, P<0.001], and less postoperative nausea and vomiting(20.0% vs.48.0%, P=0.037). Conclusions:For elderly patients after colon cancer surgery, transverse abdominis plane and rectus sheath block with Dexmedetomidine plus Ropivacaine can enhance the analgesic effect, prolong the time of effective analgesia, reduce the amount of Morphine used postoperatively, and is beneficial for early recovery.
