Effect Of Transversus Abdominis Plane Block On Perioperative Cardiac Events In Diabetic Patients Undergoing Gynecological Laparoscopic Surgery

Objective:To explore the effect of transversal abdominis plane block on perioperative cardiac events in diabetic patients undergoing gynecological laparoscopic surgery.Methods:Forty-two type 2 diabetic patients who scheduled for gynecological laparoscopic surgery in the Second Hospital of Shanxi Medical University from February 2022 to September 2022 were selected and randomly divided into experimental group（group A,21 cases）and control group（group B,21 cases）according to random number table method.The experimental group underwent ultrasound-guided transversal abdominal plane block combined with general anesthesia.The control group underwent surgery only under general anesthesia.The two groups were compared for the heart rate（HR）,mean arterial pressure（MAP）and perioperative cardiovascular events of patients at 3 time points:30 min before surgery（T₁）,at T₂ and immediately after surgery（T₃）.Serum neuropeptide Y（NPY）and cardiac troponin I（c Tn I）concentrations were measured at T₁and 24 h after surgery（T₄）.Results:There were no significant changes in MAP between the two groups（P>0.05）.The HR of the two groups at T₂ were 69.2±5.0 and（74.2±4.3）times per minute,respectively,and the difference was statistically significant（P<0.05）.There was no significant difference in the occurrence of ACVE between the two groups（28.6%vs.57.1%,P<0.05）.The concentration of NPY in serum at T₄ was 251.4±28.1 ug/L and（303.9±33.3）ug/L in the experimental group and control group,respectively,and the difference was statistically significant（P<0.05）;compared with 204.6±32.9 ug/L and（210.7±31.9）ug/L in the same group at T₁,the differences were statistically significant（P<0.05）.The concentration of c Tn I in serum at T₄ in the control group was（29.5±2.0）ng/L,which was significantly different from that at T₁（25.4±2.2）ng/L（P<0.05）;compared with the experimental group that the serum c Tn I concentration at T₄ was（24.7±2.5）ng/L,the difference was statistically significant（P<0.05）.Conclusion:For diabetic patients undergoing gynecological laparoscopic surgery,TAPB can regulate perioperative sympathetic nerve activity and stress response and stabilize the myocardium,which may play a role in the perioperative cardiac protection.