右美托咪定联合罗哌卡因腹横肌平面阻滞在腹腔镜结直肠癌手术患者中的应用研究

Application of Dexmedetomidine Combined with Ropivacaine for Transversus Abdominis Plane Block in Patients Undergoing Laparoscopic Surgery for Colorectal Carcinoma

目的:探讨右美托咪定联合罗哌卡因腹横肌平面阻滞(TAPB)在腹腔镜结直肠癌手术患者中的应用效果。方法:选择2022年1~12月于我院拟择期全麻下行腹腔镜结直肠癌手术的80例患者,随机分为对照组和研究组,每组40例,对照组应用罗哌卡因进行TAPB,研究组联合应用右美托咪定和罗哌卡因进行TAPB,比较2组手术情况以及术后恢复情况。结果:2组手术时间和术中出血量比较,差异均无统计学意义,P>0.05;研究组术后镇痛泵首次按压时间晚于对照组,总按压次数少于对照组,P<0.05;研究组术后首次排气时间、首次排便时间、首次下床活动时间、住院时间均短于对照组,术后24 h认知障碍发生率低于对照组,P<0.05;2组麻醉不良反应发生率比较差异无统计学意义,P>0.05。结论:对于全麻下行腹腔镜结直肠癌手术者,辅以右美托咪定+罗哌卡因TAPB,可提高术后镇痛效果,有助于患者术后快速恢复,而且可降低术后认知障碍发生率。

Objective To investigate the effect of Dexmedetomidine combined with Ropivacaine for transversus abdominis plane block(TAPB)in patients undergoing laparoscopic surgery for colorectal carcinoma.Methods A total of 80 patients undergoing laparoscopic surgery for colorectal carcinoma under general anesthesia in our hospital from January to December 2022 were selected and randomly divided into the control group and the study group,with 4O cases in each group.Ropivacaine was used for TAPB in the control group while Dexmedetomidine and Ropivacaine were used for TAPB in the study group.The operation status and postoperative recovery of the two groups were compared.Results There was no significant difference in the operation time and intraoperative blood loss between the two groups(P>0.05).The first pressing time of postoperative analgesic pump in the study group was later than that in the control group,and the total pressing number of postoperative analgesic pump was less than that in the control group(P<0.05).The first exhaust time,defecation time,the first time for ambulation and the length of hospital stay in the study group were shorter than those in the control group,and the incidence of cognitive impairment 24 h after the operation was lower than that in the control group(P<0.05).There was no significant difference in the incidence of anesthesia adverse reactions between the two groups(P>0.05).Conclusion For patients undergoing laparoscopic surgery for colorectal carcinoma under general anesthesia,Dexmedetomidine combined with Ropivacaine for TAPB can improve postoperative analgesia,help patients recover quickly after surgery,and reduce the incidence of postoperative cognitive impairment.