超声引导下右美托咪定联合罗哌卡因TAPB对腹腔镜下胃癌根治术患者的影响

Effect of Ultrasound-guided Dexmedetomidine Combined with Ropivacaine TAPB on Patients Undergoing Laparoscopic Radical Gastrectomy for Gastric Cancer

目的:探究超声引导下右美托咪定联合罗哌卡因腹横肌平面阻滞(transversus abdominalis plane block,TAPB)对腹腔镜下胃癌根治术患者的影响。方法:选取2020年1月—2023年3月福建医科大学附属漳州市医院64例行腹腔镜下胃癌根治术的患者,根据麻醉方案不同分为A组(n=32)和B组(n=32)。两组均采用全身麻醉,在此基础上,B组采用超声引导下罗哌卡因TAPB,A组采用超声引导下右美托咪定联合罗哌卡因TAPB。比较两组麻醉诱导前(T_(0))、气管插管时(T_(1))、阻滞时(T_(2))、切皮时(T_(3))、拔管时(T_(4))平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR),术后6 h、12 h、24 h的Ramsay镇静量表(Ramsay sedation scale,RSS)评分、视觉模拟评分法(visual analogue scale,VAS)评分,以及不良反应发生情况。结果:T_(0)、T_(4),两组MAP、HR比较,差异无统计学意义(P>0.05);T_(1)、T_(2)、T_(3),A组MAP、HR较B组低,差异有统计学意义(P<0.05)。术后6 h、12 h、24 h,A组RSS评分、VAS评分较B组低,差异有统计学意义(P<0.05)。A组不良反应发生率与B组比较,差异无统计学意义(P>0.05)。结论:超声引导下右美托咪定联合罗哌卡因TAPB用于腹腔镜下胃癌根治术患者中,麻醉效果良好,术中患者血流波动较小,不明显增加不良反应,安全性较高。

Objective:To investigate the effect of ultrasound-guided Dexmedetomidine combined with Ropivacaine transversus abdominalis plane block(TAPB)on patients undergoing laparoscopic radical gastrectomy for gastric cancer.Method:A total of 64 patients who underwent laparoscopic radical gastrectomy for gastric cancer in Zhangzhou Affiliated Hospital of Fujian Medical University from January 2020 to March 2023 were selected and divided into group A(n=32)and group B(n=32)according to different anesthesia programs.Both groups were given general anesthesia.On this basis,ultrasound-guided Ropivacaine TAPB was used in group B,and ultrasound-guided Dexmedetomidine combined with Ropivacaine TAPB was used in group A.The mean arterial pressure(MAP)and heart rate(HR)before anesthesia induction(T_(0)),during endotracheal intubation(T_(1)),block(T_(2)),skin resection(T_(3)),extubation(T_(4)),and the Ramsay sedation scale(RSS)scores and visual analogue scale(VAS)scores at 6 h,12 h and 24 h after surgery,and the occurrence of adverse reactions were compared between the two groups.Result:There were no significant differences of MAP,HR at T_(0),T_(4) between the two groups(P>0.05).T_(1),T_(2),T_(3),MAP and HR in group A were lower than those in group B,and the differences were statistically significant(P<0.05).At 6 h,12 h and 24 h after surgery,the RSS scores and VAS scores of group A were lower than those of group B,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between group A and group B(P>0.05).Conclusion:Ultrasound-guided Dexmedetomidine combined with Ropivacaine TAPB has a good anesthetic effect in patients undergoing laparoscopic radical gastrectomy for gastric cancer.The intraoperative blood flow fluctuation of patients is small,and adverse reactions are not significantly increased,and with high safety.