Effect Of Dexmedetomidine Combined With Transverse Abdominis Plane Block On Postoperative Nausea And Vomiting In Patients With Colon Tumor

Objective:This study mainly discusses the effect of continuous intravenous injection of dexmedetomidine combined with ultrasound-guided abdominal transverse muscle plane block on PONV in patients undergoing laparoscopic radical colon cancer surgery.Methods :Patients who underwent laparoscopic radical resection of colon cancer in the Affiliated Hospital of Guilin Medical University from April 2020 to December 2020 were selected,a total of 75 cases,ASA grade I or II,were randomly divided into 3 groups with 25 cases in each group:The control group was Q group,the transverse abdominis plane block group was F group,and the F+D group was the transverse abdominis plane block plus dexmedetomidine group.Group Q received gene ral anesthesia.before operation,group F and group F+D completed bilateral transverse abdominal muscle plane block under ultrasound.the local anesthetic used was ropivacaine,with a total amount of 40 ml on both sides and a concentration of0.375%.After transverse abdominis plane block,0.5ug/(kg.h)dexmedetomidine pump was used in F+D group until 30 minutes before the end of surgery.The incidence of nausea and vomiting 0-2h(T1),2-12h(T2),12-24h(T3)after surgery and the level of postoperative nausea and vomiting were recorded;Intraoperative anesthetic drug dosage was counted,and the time of tracheal catheter removal and the time of the first gastrointestinal exhaust after surgery were compared.The pain degree of the patients at 2h,12 h and 24 h after surgery was monitored and recorded by visual analog scale(VAS).Results:(1)There was no statistical significance in general information among the three groups(P > 0.05).(2)Within 24 hours after surgery,the incidence of grade II PONV in F group and F+D group was lower than that in Q group,and F+D group was lower than that in F group(P < 0.05).There was no significant difference in the incidence of grade III and grade IV PONV among the three groups(P > 0.05).(3)Within 24 hours after surgery,The overall incidence of PONV was higher at T2.Compared with the Q group,the incidence of nausea and vomiting in group F and F+D at time T2 was less(P < 0.05),and the number of PONV in the F+D group was less than that in the F group(P < 0.05).However,there was no significant difference in the incidence of PONV among the three groups in other time periods(P > 0.05).(4)Compared with the Q group,the total amount of remifentanil and propofol in the F group and F+D group was lower(P > 0.05),and F+D group was less than F group(P > 0.05).(5)Compared with the Q group,the VAS scores of the F and F+D groups were lower at 2h and 12h(P < 0.05),but there was no significant difference between the three groups at24h(P > 0.05).(6)Compared with group Q,the extraction time of tracheal catheter in group F and F+D was shorter(P < 0.05),but there was no significant difference between group F and F+D(P > 0.05).Compared with group Q,the first anal exhaust time of group F and F+D was shorter(P < 0.05),and that of group F+D was shorter(P < 0.05).Conclusions:When TAPB is applied in laparoscopic radical resection of colon cancer,it can effectively reduce the incidence of PONV,reduce the incidence of PONV in patients,and promote postoperative gastrointestinal recovery,and combined with dexmedetomidine has a better effect.TAPB was also effective in reducing early postoperative pain and shortening the time of tracheal catheter removal,and intravenous combination with dexmedetomidine did not prolong postoperative recovery time.