Clinical Analgesic Effect Of Ropivacaine Combined With Dexmedetomidine In Different Routes

Purpose:To compare the postoperative analgesic effect and adverse reactions of dexmedetomidine in different routes of administration of compound ropivacaine nerve block and to measure the serum IL-6,TNF-? inflammatory factors,SOD,and oxidative stress after operation Product MDA and other levels of influence.Method:90 patients undergoing partial hepatectomy and ASA I-II grades 30 to 60 years old were randomly divided into three groups: 0.33% ropivacaine 30 mL/saline 3 mL(TAP)+ saline 10 mL(iv)(R group),0.33% ropivacaine 30mL/0.5ug/kg Dextrin diluted to3mL(TAP)+ saline 10mL(iv)(RpD group),0.33% ropivacaine30mL/saline 3mL(TAP)+ 0.5ug/kg Right-diluted was diluted to 10 mL(iv)(RsD group),30 cases in each group.Record the time of first need for analgesic drugs in each group,24 h sufentanil dose,1h,2h,4h,24 h VAS scores after operation;before and,2h,4h,24 h postoperative venous blood determination Interleukin-6(interleukin-6,IL-6),tumor necrosis factor-?(TNF-?),SOD,and malondialdehyde(MDA)concentrations;the occurrence of adverse reactions in three groups of patients was recorded(nausea,Vomiting,lethargy,hypotension,bradycardia).Results:The levels of IL-6,TNF-?,MDA,and SOD in the three groups were not statistically different at T0.Compared with T0,at the time of T1,T2,and T3,the levels of IL-6,TNF-?,and MDA in the three groups were significantly higher(P<0.05),SOD levels were significantly decreased(P<0.05),and compared with R group,T1.At the time of T2 and T3,the levels of IL-6,TNF-? and MDA in patients with RpD and RsD were significantly decreased(P<0.05),and the SOD levels were significantly higher(P<0.05).Compared with RsD group,T1,T2,T3 At the time,the levels of IL-6,TNF-? and MDA in the RpD group were significantly decreased(P<0.05),and the SOD level was significantly higher(P<0.05).Compared with group R,VAS scores decreased significantly at each time point in the RpD and RsD groups,and total sufentanil decreased significantly after 24 hours(P<0.05).Compared with the RsD group,the VAS scores of the RpD group decreased significantly at each time point.The total amount of sufentanil decreased significantly after 24 hours(P<0.05).There was no significant difference in the incidences of age,sex ratio,weight,operation time,postoperative adverse reactions(nausea,vomiting,drowsiness,hypotension,bradycardia)among the three groups(P>0.05).Conclusion:The combination of dexmedetomidine and peripheral nerves combined with ropivacaine nerve block can better relieve postoperative pain.The mechanism may be related to the effective reduction of postoperative stress response and release of noxious inflammatory factors.