Effect Of Dexmedetomidine Combined With Transverse Abdominis Plane Block On Postoperative Gastrointestinal Function In Patients Undergoing Laparoscopic Colorectal Surgery

Objective:To investigate the effects of dexmedetomidine（DEX）combined with transversus abdominis plane block（TAPB）on postoperative gastrointestinal function in patients undergoing laparoscopic colorectal surgery.Methods:A total of 82 patients with elective laparoscopic colorectal surgery were selected,all of whom were hospitalized in the general surgery department of the Second Hospital of Hebei Medical University from February 2020 to December 2020.ASA Ⅰ～Ⅲ grade,aged 18 to 65 years,both sex.By random number table method,they were divided into two groups:DEX+TAPB experimental group（group Ⅰ）and normal saline control group（group Ⅱ）,with 41 patients in each group.Before anesthesia induction,group Ⅰ was pre-pumped with DEX 0.5ug/kg（10min）,group Ⅱ was pre-pumped with0.9%normal saline of the same dose（10min）,and group Ⅰ was given bilateral TAPB（0.375%ropivacaine 20ml/side）,during operation,group Ⅰ was pumped with DEX 0.4ug·kg^-·¹h^-1,while group Ⅱ was pumped with 0.9%normal saline of the same dose.Record the I-FEED scores at 24,48,72 and96h after surgery and the incidence of postoperative gastrointestinal dys-function（POGD）;the intraoperative pump dosage of remifentanil,the visual analogue scale（VAS）at 24,48 and 72h after surgery and analgesic pump pressure times;first exhaust and defecation time,first oral intake time,first leaving bed time after operation and the incidence of postoperative nausea and vomiting（PONV）in 24h after surgery.Results:1.The I-FEED scores of group Ⅰ at 24,48,72 and 96h after surgery were all lower than those of group Ⅱ.The incidence of POGD in group Ⅰ was 7.32%,and that in group Ⅱ was 34.15%,which was significantly lower in group Ⅰ than in group Ⅱ,with statistical significance（P<0.05）;2.The intraoperative pump dosage of remifentanil,VAS at 24,48 and72h after surgery,and the number of postoperative analgesic pump compresses in group Ⅰ were all lower than that in group Ⅱ,with statistical significance（P<0.05）;3.There was no statistically significant difference in the first exhaust time after operation between group Ⅰ and group Ⅱ（P=0.05）.The first defecation time,first oral intake time and first leaving bed time in group Ⅰ were significantly shorter than those in group Ⅱ,with statistical significance（P<0.05）.4.The incidence of PONV in group Ⅰ was 19.51%,while that in group Ⅱ was 48.78%.The incidence in group Ⅰ was significantly lower than that in group Ⅱ,with statistical significance（P<0.05）;Conclusions:The combination of dexmedetomidine and transverse abdominis plane block for patients undergoing laparoscopic colorectal surgery can accelerate the recovery of gastrointestinal function,reduce the incidence of POGD,reduce postoperative nausea and vomiting,and promote postoperative recovery of patients.