Analgesic Effect Of Dexmedetomidine Combined With Ropivacaine Transverse Abdominis Muscle Plane Block In Gynecological Laparoscopic Surgery

Objective: To investigate the analgesic effect of dexmedetomidine nerve block and intravenous injection combined with transversus abdominis plane block on gynecological laparoscopic surgery.Methods: According to the inclusion and exclusion criteria,63 patients who underwent laparoscopic hysterectomy in the First Affiliated Hospital of Chongqing Medical University were selected and randomly divided into 3 groups.DIV group: dexmedetomidine 1ug/kg intravenous infusion,0.33% ropivacaine for bilateral transversus abdominis plane block,15 ml on each side;DTAP group: dexmedetomidine 1ug/kg and 0.33%ropivacaine mixture 30 ml was used for bilateral transverse abdominis plane block,15 ml on each side;RTAP group: 0.33% ropivacaine was used for bilateral transverse abdominis plane block,15 ml on each side.Record the static and dynamic VAS scores of T1(1h after operation),T2(2 hours after operation),T3(6h after operation),T4(12h after operation),T5(24h after operation),T6(48h after operation)and BCS score,the number and frequency of PCIA compressions within 24 hours after surgery,and the incidence of adverse reactions and complications in patients within 48 hours after surgery.Results: 2h,6h,12 h,and 24 h postoperatively,the resting and dynamic VAS scores of the DTAP group were lower than those of the RTAP group(P<0.05);2h,6h,and 12 h postoperatively,the resting VAS and dynamic VAS scores of the DIV group were higher than those of RTAP Group low(P<0.05);12h and 24 h after operation,the dynamic VAS score of DTAP group was lower than that of DIV group(P<0.05);there was no significant difference in PCIA usage between the three groups(P>0.05);There was no significant difference in the incidence of nausea and vomiting among the three groups(P > 0.05).Conclusion: Dexmedetomidine combined with transversus abdominis plane nerve block used in laparoscopic hysterectomy can enhance the analgesic effect of transversus abdominis plane block,and the analgesic effect of dexmedetomidine combined with local anesthetics for nerve block is stronger than that of intravenous route when the same dose of dexmedetomidine is added.