Effects Of Different Modes Of Ultrasound-Guided Nerve Block On Postoperative Analgesia After Laparoscopic Cholecystectomy

Objective: To evaluate the postoperative analgesia of different models of nerve block on laparoscopic cholecystectomy under the enhanced recovery after surgery(ERAS).Methods:80 patients with laparoscopic cholecystectomy,aged 30 to 60 years,ASAⅠ～Ⅱ,were randomly divided into four groups(n=20).Group T: Ultrasound guided right lateral costal inferior lateral abdominal plane block after surgery(transversus abdominis plane block,TAPB),0.25% ropivacaine+0.5μg/kg dexmedetomidine 30ml;Group R: TAP B+right rectus sheath block rectus sheath block(Rectus sheath block;RSB),0.25% ropivacaine+0.5μg/kg dexmedetomidine 30ml;group P:intravenously controlled analgesia group(sulfentanil 1μg/kg+dexmede tomidine 1μg/kg+dezocine 0.4mg/kg);group N: blank control group.The vital signs at 1h(T1),6h(T2),12h(T3),and 24h(T4),the RPP(heart rate systolic blood pressure product),resting and active VAS scores,Ramsay sedation scores,and BCS comfort score and adverse events.Results:Ramsay sedation scores were not significantly different between the four groups(P>0.05).RPP: Compared with group N,group R and P were significantly reduced at each time point(P<0.05),and there was no significant difference between groups R and P(P>0.05).VAS scores(resting)and VAS scores(activity)have the same changes in the two monitoring indicators:group R,T and P are significantly reduced compared with group N at each time point(P<0.05).There was no statistical difference between them(P>0.05).The group T was significantly higher than group R and P at T2 and T3(P<0.05).BCS comfort score: Compared with the control group,the BCS comfort score at each time point of group R and T was significantly increased,and group P was significantly decreased at T4(P<0.05),and it was significantly different from group R(P<0.05).Adverse reactions: The incidence of dizziness,nausea and vomiting in patients in group P at T3 and T4 were significantly different from those in group R,T and N(P<0.05).Conclusions:After laparoscopic cholecystectomy,0.25% ropivacaine+dexmede tomidine for the right lateral costal inferior abdominal transverse muscle plane block+rectus sheath block can effectively reduce postope rative pain and increase comfort,and there were no obvious adverse reactions.