Analysis Of Perioperative Analgesic Effect Of Dexmedetomidine Combined With Ropivacaine TAP Block For Reducing Ovarian Cancer Cells In Laparotomy

Objective:To evaluate the efficacy of dexmedetomidine combined with ropivacaine in perioperative analgesia during laparotomy of ovarian cancer tumor cell reduction.Methods:Sixty patients with intermediate and advanced ovarian cancer,aged 18～60 years old,body mass index 18～26kg/㎡,ASAI.grade or II.grade,all patients underwent open ovarian cancer cytoreductive surgery,and the operation was carried out from June 2021 to June 2022.According to the random number table method,the patients were divided into two groups,30 cases in the ropivacaine group(L group),and 30 cases in the dexmedetomidine combined with ropivacaine group(LD group).Before anesthesia induction,bilateral transverse abdominis plane block(subcostal approach and midaxillary line approach)was performed under ultrasound guidance,and 20 ml of 0.25% ropivacaine solution was injected in each subcostal margin approach and midaxillary line approach in L group,with a total of 80 ml on both sides.In the LD group,0.25% ropivacaine solution +1μg/kg dexmedetomidine solution was injected under the rib margin and in the midaxillary line approach on each side,with a total of 80 ml on both sides.The changes of norepinephrine(NE)and epinephrine(E)concentrations and blood pressure and heart rate in the first 10 min(T0)and 5 min(T7)after extubation were compared between the two groups.The postoperative awakening time was recorded,and the pain VAS score(visual analogue score)of the two groups was collected at 6 time points,including 2h(T1)after extubation,6h(T2)after extubation,12h(T3)after extubation,24h(T4)after extubation,36h(T5)after extubation,and 48h(T6)after extubation.Results:1.There was no significant difference in plasma NE and E concentration,systolic blood pressure,diastolic blood pressure and heart rate level in T0(all P>0.05),and there was a significant difference in T7(all P<0.05),and the LD group was lower than that in L group(P<0.05);2.The pain VAS scores of the two groups at 6 postoperative time points were compared,and the LD group was lower than that in the L group(all P<0.05).(3)There was a difference in the number of uses of intravenous self-controlled analgesia pumps in 24 hours after surgery between the two groups,and the number of uses of patients in the L group was higher than that in the LD group,and the statistical difference was obvious(all P<0.05).(4)The adverse reactions of patients in the two groups mainly included dizziness,nausea and hypotension,and statistical analysis showed that the incidence of LD group was lower than that of L group,but the difference between groups was not statistically significant(P>0.05).Conclusions:Dexmedetomidine combined with ropivacaine can effectively prolong the analgesic time of transtransverse abdominal block and reduce the use of drugs.