Effect Of Multimodal Preventive Analgesia On Analgesic Effect During Resuscitation In Patients With Liver Cancer Surgery

Objective: To investigate the effects of local anesthesia with ropivacaine combined with dexmedetomidine multimodal preventive analgesia on analgesic effect during resuscitation in patients undergoing liver cancer surgery.Methods: 60 patients with liver cancer who underwent partial hepatectomy were randomly divided into 3 groups by random number table method,local infiltration anesthesia of ropivacaine before skin incision combined with dexmedetomidine is group M1,local infiltration anesthesia of ropivacaine before suture combined with dexmedetomidine is group M2 and group C is control group with no dexmedetomidine and local infiltration anesthesia for incision,and each group had 20 cases.In group M1,intravenous infusion of dexmedetomidine 0.5?g/kg before 20 min induction,and 0.25%ropivacaine 40 ml was given to infiltrate the incision 5~10min before operation;In group M2,intravenous infusion of dexmedetomidine 0.5?g/kg before 20 min induction,and 0.25% ropivacaine 40 ml was used to infiltrate the incision before sewing skin;In group C did not have local infiltration anesthesia with dexmedetomidine,and the rest treatments were the same.Three groups of patients received routine postoperative intravenous self-control analgesia.The observation time points are divided into the following 9: including before induction of anesthesia(T1)?Skin cutting(T2)?30min after skin cutting(T3)?Liver cutting(T4)?At the end of the operation(T5)?before extubation(T6)?2hours after operation(T7)?3 hours after operation(T8)?4 hours after operation(T9).The scores of sedation(Ramsay),sedative and exercise(cough)pain scores(VAS)were recorded in three groups at T6,T7,T8 and T9 points.The mean arterial pressure(MAP)and heart rate(HR)at each time point of the three groups were recorded.Record the occurrence of adverse reactions.Results: There was no significant difference in Ramsay scores at each time point after operation(P > 0.05).In group M1 and group M2,sedative and coughing VAS scores were lower than those in group C at T6,and the number of patients with moderate or above pain was less than that of group C,the differences are statistically significant(P<0.05).Coughing VAS scores in group M2 was lower than that in group C at the time point of T7 and T8,the differences are statistically significant(P<0.05).The MAP value of the group M1 at T2 and T3 points is significantly lower than that of the group C(P<0.05),the value of MAP in group M1 and M2 at T5 and T6 points is obviously lower than that in group C(P < 0.05).There was no significant difference in HR between groups at all time points(P > 0.05).And there was no significant difference in the incidence of postoperative adverse reactions between the three groups(P>0.05).Conlusion: Ropivacaine and local invasive anesthesia combined with dexmedetomidine for multimodal preventive analgesia can effectively reduce the degree of pain in the resuscitation period of the patients with liver cancer,and local infiltration anesthesia before suture is better than that before skin incision in resuscitation.And have no obvious adverse reactions.