Effect Of Different Doses Of Dexmedetomidine Combined With Ropivacaine Transverse Abdominal Plane Block On Postoperative Analgesia

Objective:To observe the analgesic effects of different doses of dexmedetomidine combined with ropivacaine under ultrasound-guided transversus abdominis plane block in gynecological open surgery and discuss the appropriate clinical dose of dexmedetomidin in ropivacaine.Methods:A total of 60 patients undergoing gynecological open surgery under general anesthesia from March 1,2017 to December 30,2017,using a completely randomized grouping method were divided into four group,with 15 patients in each group.Ultrasound-guided transversus abdominis plane block was performed bilaterally after general anesthesia using 20 ml of 0.2% ropivacaine combined with normal saline each side in the control group,and 6.25 ug,12.5ug or 25 ug of dexmedetomidine in three treatment groups.Patient-controlled intravenous analgesia pump was used in all patients after operation.The four groups of patients were transferred to the recovery room after operation.VAS scores of patients in four groups after levaing PACU,4h,8h,12 h,24h,48 h by the duration of bilateral TAP block ending were recorded.The times from the first PCA to bilateral TAP block ending and postoperative 48 h PCIA compression numbers were recorded.Postoperative adverse reactions and discharge time in patients of four groups were recorded.The measurement data were expressed by mean± standard deviation.The repeated measures data were used for variance analysis in the group.The single factor ANOVA,LSD test and chi square test were used to compare the difference between the groups.The difference was statistically significant in P<0.05.Results:The times to request for postoperative analgesia were mean 4.60 h in the control group and 4.64 h,7.92 h,11.0h in the 6.25 ug,12.5ug,25 ug treatment groups,respectively.As the dose increased,the VAS score at different times of the patient gradually decreased.Conclusion:Dexmedetomidine combined with ropivacaine under ultrasound-guided transversus abdominis plane block could improves the time of postoperative analgesia as the dosage increases.