Effects Of Different Doses Of Dexmedetomidine Combined With Ropivacaine On Analgesia After Cesarean Section

Objective:To investigate the ultrasound-guided effects of different doses of dexmedetomidine combined with ropivacaine on the transverse abdominal plane block combined with iliohypogastric nerve block for analgesia after cesarean section.Methods:A total of 76 women who underwent elective cesarean section under combined spinal and epidural anesthesia were randomly divided into 4 groups according to the randomized table method.Each group had 19 cases.Each group underwent ultrasound-guided bilateral abdominal transverse plane block in combination with iliohypogastric nerve block,the volume of the local anesthetic mixture on both sides of the transverse abdominal muscle block was 20 ml,and the anesthesia fluid on both sides of the iliac abdominal muscle block was 5 ml.Con group local anesthetic mixture contains 0.2%ropivacaine,Dex 1 group local anesthetic mixture contains 0.5 ?g/kg dexmedetomidine+0.2%ropivacaine,Dex 2 group local anesthetic mixture contains 1.0 ?g/kg dexmedetomidine +0.2%ropivacaine,Dex 3 local anesthetic mixture contains 1.5 ?g/kg dexmedetomidine+0.2%ropivacaine,each group of local anesthetic mixture was diluted with normal saline to a volume of 50 ml.Besides,patient-controlled intravenous sufentanil analgesia pump was provided to all patients.VAS in quiescent condition or in movement 6 h,8 h,12 h,24 h and 48 h after operation were assessed.Pressing times of analgesia pump within postoperative 24 h,redeem rate of analgesia and sufentanil dosage were compared between four groups.The postoperative anal exhaust time,the first time of priming and the satisfaction with postoperative analgesia were recorded.Record the occurrence of postoperative adverse reactions in each group of women.Results:Compared with group Con and group Dex 1,values of pressing times of analgesia pump within post-operative 24 h in group Dex 2 and group Dex 3,redeem rate of analgesia and sufentanil dosage were significantly lower(P<0.05).And shortened the colostrum secretion time of patients,promoted the early anal venting of patients after operation(P<0.05).There was no significant difference no matter in quiescent condition or in movement in each period after operation in each group(P>0.05).Moreover,compared with group Con and group Dex2,the incidence of xerostomia in group Dex3 was more commonly occurred(P<0.05).Conclusion:When dexmedetomidine dose is 1.0 ?g/kg and 1.5 ?g/kg,compound 0.2%ropivacaine can significantly enhance the analgesic effect after cesarean section for transverse abdominal plane block combined with iliohypogastric nerve block.And the dexmedetomidine dose of 1.0 ?g/kg caused less postoperative adverse reactions.