Effects Of Postoperative Analgesia With Dexmedetomidine And Sufentanil Combined With Transverse Abdominis Muscle Plane Block On The Recovery In Elderly Patients After Colorectal Surgery

Objective:To assess the effect,safety and postoperative recovery of dexmedetom-idine and sufentanil combined with transversus abdominis plane block for postoperative analgesia for elderly patients undergoing laparoscopic colorectal cancer surgery.Methods:Sixty patients,falling into ASA physical ststusⅠtoⅢ,aged 65 or higher,BMI18～25kg/m~2,undergoing laparoscopic colorectal cancer surgery and using paint-controlled intravenous analgesia voluntarily were randomized divided into two groups.The patients in group ST were treated with sufentanil through PCIA,the patients in group STD were treated with sufentanil and dexmedetomidine through PCIA.The patients in two gro-ups received ultrasound-guided TAPB with 0.25%ropivacaine 20ml.The changes of VAS and Ramsay score,the counts of PCA pump compressions and the effective compre-ssions,the dosage of sufentanil,pain relief cases,the occurrence of various postoperative adverse reactions,postoperative intestinal function recorded time,the first time to get out of bed,length of hospital stay were recorded.From the first day to the 3rd day after operation,the delirium occurrence was evaluated.Eurocognitive disorder was used to assess delayed neurocognitive recovery on the first day before operation and the seventh day after operation.Qo R-15 was used to assess recovery quality on the postoperative 24 h and 48 h.Results:Compared with group ST,VAS score at rest 12 hours and in acttivity 12hours postoperatively were significantly decreased in group STD(P<0.05).Compared with group ST,the counts of PCA pump compressions and the effective compressions,the consumption of sufentanil and the incidence of nausea were significantly decreased in gro-up STD(P<0.05).Compared with group ST,the incidence of delayed neurocognitive recovery was significantly decreased in group STD(P<0.05).Compared with group ST,the length of hospital stay was significantly shortened in group STD(P<0.05);Compared with group ST,the recovery quality scores at postoperative 24h and 48h were significantly increased in group STD(P<0.05);VAS score at postoperative 2h,6h,24h and 48h,ramsay score,pain relief cases,the first time to get out of bed,incidence of delirium,vomitng,bradycardia and hypotension had no significant difference.Conclusion:For elderly patients undergoing laparoscopic colorectal cancer surgery,dexmedetomidine and sufentanil combined with transverse abdominis muscle has a good analgesic effect,which can reduce the incidence of delayed neurocognitive recovery,accelerate postoperative recovery and shorten the length of hospital stay.