Research On The Medium Effective Concentration And Block Effect Children Abdominal Surgery Under Ultrasound Guided Transversus Abdominis Plane Block Of Ropivacaine Mesylate

Objective: To discuss the ultrasound abdominal surgery in children under guided transversus abdominis plane block(Transversus abdominis,plane,TAPB)the medium effective concentration of Ropivacaine Mesylate and block effect,in order to provide reference for children abdominal surgery under anesthesia.Methods: In the first stage,the sequential method was used to determine the median effective concentration of TAPB mesylate ropivacaine under ultrasound guidance by using different concentrations of ropivacaine mesylate.In the second stage,120 children undergoing lower abdominal surgery were selected and randomly divided into groups A,B and C,with 40 patients in each group.Group A received ultrasound-guided sedation with propofol combined with TAPB anesthesia,group B received total intravenous anesthesia(TIVA),and group C received sevoflurane anesthesia.Comparison of children into the operation room(T0),incision of skin(T1),stretch lesions(T2)and recovery(T3)hemodynamic parameters at each time point of children,including systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),mean arterial pressure(MAP)and oxygen saturation(SPO2),recorded anesthesia complications,statistics of the total amount of propofol in group A and B,and statistics of the total fentanyl in each group,the children were recorded the recovery time,PACU stay time,the pain of Dongan children’s Hospital of Ontario(The Children Hospital of Eastern score Ontario Pain Scale,CHEOPS)were recorded after 2,4,8,12 h CHEOPS score,postoperative analgesia pressing times.Results: The medium effective concentration of Ropivacaine Mesylate in children undergoing lower abdominal surgery under ultrasound guidance wasstudied in 25 children under TAPB guidance,the medium effective concentration was 0.253%(95%CI:0.226%~0.298%),95% effective concentration was 0.316%(95%CI:0.253%~ 0.327%).The second stage,each group of children were scheduled to complete the operation.Group A at each time point T1~T3 SBP,DBP,HR,MAP were lower than group B,C(P <0.05 or P<0.01),postoperative restlessness,nausea and vomiting and the incidence rate of complication were lower than group B and group C(P<0.05 or P<0.01),the dosage of propofol in group A was lower than that in group B,the dosage of fentanyl in group A was lower than that of group B and group C,the recovery time,PACU observing time was less than group B and group C(P <0.05),after2,4,8 h CHEOPS scores in group A were lower than that in group B and group C(P <0.05),analgesia pressing times in group A were lower than that in group B and group C(P <0.05).SBP,DBP,HR,MAP,SPO2,postoperative agitation,nausea and vomiting,skin itching,dizziness,chest tightness and total complication rate,propofol and fentanyl intravenous anesthesia drug dosage,recovery time,PACU stay time,the CHEOPS scores,and analgesia pressing times between group B and group C,difference no statistical significance(P >0.05).Conclusion: Medium effective concentration children abdominal surgery under ultrasound guided transversus abdominis plane block of Ropivacaine Mesylate was 0.253%,95% effective concentration was 0.316%.Under the guidance of ultrasound,0.316% Ropivacaine Mesylate TAPB combined with propofol sedation anesthesia,the effect is accurate,intraoperative and postoperative analgesia effect is good,for children with lower abdominal surgery and so on has certain guidance and reference.