Analysis Of The Curative Effect Of Combined Use Of Ultrasound-guided Lower Abdominal Transverse Muscle Block

Objective To explore of postoperative analgesia effect of dexamethasone combined with dexmedetomidine combined with ropivacaine on transabdominal transverse plane(TAP)in patients undergoing laparoscopic abdominal surgery.Methods 120 patients with written informed consent were randomly divided into 4 groups with 30 cases in each group.The patients received routine monitoring and opened the venous passage after operation.All patients were anesthetized with the same standard general anesthesia.According to the group situation,the TAP block of bilateral axillary midline approach was performed under the guidance of ultrasound before the operation.Heart rate and heart rate,mean arterial pressure,oxygen saturation,oxygen saturation during operation,operation time and TAP block time were observed,the visual analogue score at rest and cough at 2 h,4 h,6 h,12 h and 24h after operation,visual analogue score at rest and cough,the score of postoperative digital score at rest and cough,the score of sedation and Ramsay),the time of the first time after operation were asked for analgesics.The total amount of total sufentanil consumption in 24 hours analgesia pump was accumulated in 24 hours intravenous administration.The total number of times of 24 hours analgesic pump pressing,the times of analgesic pump pressing at different time points,the quality of recovery questionnaire 40 QoS 40,the satisfaction degree of the patients,the total consumption of sufentanil in 24 h analgesia pump were calculated.Incidence of postoperative complications and complications associated with TAP block.Results1.VAS score and VNRS score of rest and cough were decreased and Ramsay scores were increased.2.Comparison between each group:the time for the first time after the operation was extended,the total amount of 24h intravenous and gezocine decreased,the consumption of sufentanil in the 24h analgesia pump decreased,the total times of 24h analgesia pump was reduced,and the press times of the analgesic pump at different time points were reduced.3.The scores and total scores of each index were increased,and the patients’ satisfaction was improved.4.The VAS scores and VNRS scores of rest and cough in Rd group and Ry group were lower than those in Rd group and Ry group.5.Comparison between Rd group and Ry group:the time of first request for analgesics was prolonged.According to the demand for analgesia,the total amount of dizosin in 24 hours was decreased.The consumption of sufentanil in 24 h analgesia pump was reduced.The total number of times of compression of 24 h analgesic pump was decreased,and the times of compression of analgesic pump at different time points were all decreased.6.Comparison between Rd group and ry group in RDY group:the scores and total scores of each index were increased,and the patients’ satisfaction was improved(P<0.05).7.There was no significant difference in the incidence of postoperative complications and those associated with TAP block(P>0.05).Conclusions Dexamethasone and dexmedetomidine combined with ropivacaine for ultrasound-guided transversus abdominis plane(TAP)block can better prolong the time of ropivacaine and increase its analgesic intensity.