Effect Of Addition Of Dexmedetomidine To Ropivacaine In Tapb On Sleep Quality In Elderly Patients Undergoing Colorectal Cancer Surgery

Object:To observe the effect of Dexmedetomidine（Dex）mixed with ropivacaine in ultrasound-guided transversus abdominis plane block（TAPB）on postoperative sleep quality in elderly patients undergoing laparoscopic radical resection of colon cancer under general anesthesia.To provide reasonable postoperative analgesia for patients and accelerate postoperative rehabilitation of elderly patients with colorectal cancer surgery.Methods:90 patients with colorectal cancer who were selected to undergo open surgery in our hospital were selected and randomly divided into 3groups（n=30）,control group（group C）,ropivacaine TAPB group（group T）and Dex mixed with ropivacaine TAPB group（group DT）.Group T and group DT received bilateral TAPB immediately after the operation:group T with 0.375%ropivacaine 20 ml on each side;group DT with 0.375%ropivacaine combined with 1.0 ug/kg Dex 20 ml on each side;The control group did not have TAPB.All patients in the 3 groups received patient-controlled intravenous analgesia（PCIA）after operation.The Pittsburgh sleep quality index（PSQI）scores were recorded on the first day before operation（T₀）,the first day after operation（T₁）,the third day after operation（T₂）and the seventh day after operation（T₃）;Record the rehabilitation quality scale-40（Qo R-40）scores of patients at T₀and T₂;Record the first time of postoperative exhaust,leaving bed and hospital stay among the three groups of patients;Record the occurrence of adverse reactions within 48h after operation.Results:1 There were no significant differences in gender,age,ASA grade,BMI,tumor growth site and surgical method among the 3 groups（P>0.05）.2 There was no statistically significant difference in PSQI scores among the3 groups at T₀（P>0.05）.Compared with group C,the PSQI scores of group T at T₁and group DT at T₁and T₂were lower,with a statistical difference（P<0.05）;Compared with group T,the PSQI score of group DT at T₁was lower,with a statistical difference（P<0.05）;There was no statistically significant difference in PSQI scores among the 3 groups at T₃（P>0.05）.3 There was no significant difference in Qo R-40 scores of the 3 groups at T₀（P>0.05）.At T₂,compared with group C,the physical comfort,pain and total Qo R-40 score of group T and the physical comfort,emotional state,pain and total Qo R-40 score of group DT were significantly higher,with a statistical difference（P<0.05）;Compared with group T,the physical comfort,pain and total Qo R-40 score in group DT were significantly higher,with a statistical difference（P<0.05）.4.Comparison of the first time of postoperative exhaust and leaving bed,group C>group T>group DT,with a statistical difference（P<0.05）.There was no significant difference in hospital stay among the 3 groups（P>0.05）.5.There was no statistical significance in the occurrence of postoperative adverse reactions such as nausea and vomiting,respiratory depression,intestinal obstruction,bradycardia and hypotension among the 3 groups（P>0.05）.Conclusion:（1）TAPB used for postoperative analgesia of colorectal cancer surgery can improve the sleep quality of elderly patients after surgery,which is conducive to the early recovery of patients after surgery;（2）The combination of ropivacaine and Dex for TAPB can enhance the analgesic effect,prolong the action time,and do not increase the occurrence of adverse reactions;（3）Dex combined with ropivacaine TAPB can significantly improve the sleep quality of elderly patients after surgery,accelerate the recovery of intestinal function,and have a positive effect on the rapid recovery of patients after surgery.