Different Doses Of Dexmedetomidine Combined With Ropivacaine TAPB Assisted General Anesthesia For Postoperative Analgesia And Changes In NE EPI,IL-6 Concentration

Objective:In tumor patients undergoing elective colorectal and rectal cancer radical surgery,we studied the postoperative analgesia and NE,EPI of different doses of dexmedetomidine combined with ropivacaine for transverse abdominal muscle plane block(TAPB)IL-6 concentration change.Method: Seventy-four patients undergoing elective laparoscopic-assisted radical surgery for colorectal cancer under general anesthesia in the First People's Hospital of Changde City from March2019 to October 2019(38 patients with colon cancer and 36 patients with rectal cancer,respectively)),and randomly divided patients into three groups.D1 group,D2 group and D3 group used 20 ml of 0.375%ropivacaine alone(group D1),dexmedetomidine 0.5?g / kg combined with 0.375% ropivacaine 20 ml after induction of tracheal intubation under general anesthesia(group D1)D2 group)or dexmedetomidine 1?g/ kg combined with 0.375% ropivacaine total 20ml(D3 group)bilateral TAPB,10 ml on each side.All patients were connected to an intravenousanalgesic pump 15 minutes before the end of the operation for postoperative intravenous analgesia(PICA).Record the patient's heart rate(HR)and mean arterial pressure(MAP)before anesthesia induction(T0),at the time of skin incision(T1),at the end of surgery(T2),and 1hour after extubation(T3);record the patient after extubation 1 hour(T3),6 hours postoperatively(T4),and 24 hours postoperatively(T5)the visual analogue score(VAS)was used to assess the patient's pain level.Before the induction of anesthesia(T0),skin incision(T1),1 hour after extubation(T3),and 24 hours after operation(T5),5 mL of venous blood was drawn from the right internal jugular vein,and enzyme-linked immunosorbent assay(ELISA)was used)Method to measure the concentration of plasma norepinephrine(NE),epinephrine(EPI)and interleukin 6(IL-6).Accurately record the dosage of propofol and remifentanil during the operation,and record the operation time and the extubation time after the operation.Count the probability of postoperative adverse reactions.Result:Compared with T0,the HR and MAP of the three groups of patients were significantly lower at T1,T2 and T3(P <0.05).The HR and MAP of the three groups of patients at each time point and the amount of propofol during operation were not significantly different(P> 0.05).Compared with the D1 group,the amount of remifentanil in the D2 and D3 groups was significantly reduced(P <0.05),and the resting VAS at T3 and T4 was significantly reduced(P <0.05).Compared with T0,plasma EPI(T1,T3,T5),NE(T1,T3),IL-6(T3,T5)concentrations of patients in the three groups were significantly higher(P <0.05);compared with D1 group,D2 group The plasma EPI(T1,T5),NE(T1),IL-6(T1,T3,T5)concentrations of patients in the D2 and D3 groups were significantly reduced(P <0.05).The plasma EPI,NE,IL at each timepoint in the D2 and D3 groups There was no statistical difference between-6 concentrations.There was no significant difference in the incidence of postoperative adverse reactions among the three groups(P<0.05).Conclusion : In patients undergoing laparoscopic-assisted radical resection of colorectal and rectal cancer,preoperative dexmedetomidine(0.5?g / kg or 1?g / kg)combined with ropivacaine TAPB can provide accurate perioperative Analgesia,inhibit perioperative stress response and reduce inflammatory factor release.