Effects Of Ropivacaine Combined With Different Dosage Of Dexmedetomidine Transversus Abdominis Plane Block On The Serum Level Of Smica Protein In Rectal Cancer Patients

Objective:SMICA protein can inhibit immune effect and promote tumor development.In this study,the effect of ropivacaine combined with dexmedetomidine on serum sMICA protein level in patients with rectal cancer was investigated.Methods:One hundred cases of rectal cancer patients undergoing radical resection in our hospital were randomly divided into 5 groups?20 cases in each group?:A,B,C,D and E.After anesthesia induction,the patients in the five groups were treated with ultrasound-guided bilateral transverse abdominal muscle plane?TAP?block.Blocking drugs:group A?control group?,40ml normal saline;Group B,ropivacaine 0.33%+normal saline 40ml;In group C,a total of 40ml of ropivacaine 0.33%+dexmedetomidine 0.5 g/kg+normal saline was used.A total of 40ml of ropivacaine,0.33%,dexmedetomidine,0.75 g/kg,and normal saline were used in group D.Group E:0.33%ropivacaine+1 g/kg of dexmedetomidine+40ml of normal saline.MAP and HR of the patients before anesthesia induction?T₀?,immediately after anesthesia induction?T₁?,10 minutes after TAP block?T₂?,during tracheal extubation?T₃?,and10 minutes after extubation?T₄?were recorded.Visual Analogue Scale?VAS?,times of analgesic compressions,postoperative rehabilitation and adverse events were recorded at 6h,12h,24h and 48h after surgery.sMICA protein in serum was determined before anesthesia induction,1 day after surgery,2 days and 6 days after surgery.Results:There was no significant difference in general condition and operation time between the five groups?P>0.05?.VAS scores of patients in group D and E at 6h,12h and 24h after surgery were lower than those in group A?P<0.05?,and VAS scores of patients in each group were not statistically significant at 48h after surgery.The duration of tracheal extubation in the four experimental groups was shorter than that in the group A?P<0.05?.There were no statistically significant differences in the time of the first postoperative movement out of bed,the time of the first anal exhaust and the length of hospitalization between the two groups.Hemodynamic comparison:T2,four groups of experimental group average pressure was lower than that in group A?P<0.05?,when the T3,D,E,two groups of average lower in group A,B two groups?P<0.05?,and D,E,two groups of heart rate was lower than that in group A?P<0.05?,compared with group A,D,E,the probability of two groups appeared sinus slow significantly increased?P<0.05?,sinus group E delay probability higher than that of group D?group D minimum rate of 56 times/min,group E minimum heart rate is 50times/min?.Compared with that before anesthesia induction,the serum sMICA protein content of patients in each group showed a declining trend after surgery,and the serum sMICA protein content of patients in the fifth group on the 6th day after surgery was significantly lower than that before anesthesia induction?P<0.05?.On the6th day after surgery,the serum sMICA protein level in group D was significantly lower than that in group A?P<0.05?,and the serum sMICA protein level in group E was significantly lower than that in group A and B?P<0.05?.Conclusion:Ropivacaine combined with dexmedetomidine at different doses can reduce the content of sMICA protein in serum of patients with rectal cancer,and has a protective effect on the body's immune function.Dexmedetomidine combined with ropivacaine at 0.75ug/kg was more appropriate.