Effect Of Transversus Abdominis Plane Block Combined With Dezocine On The Inflammatory Factors Of Laparoscopic Cholecystectomy Patients

Objective:By observing the effect of dezocine?transversus abdominis plane block?transversus abdominis plane block combined with dezocine on the circulation,the dosage of anesthetics,the Resting VAS score and the inflammatory factors of laparoscopic cholecystectomy patients during intraoperative and postoperative period,the thesis discusses whether transversus abdominis plane block combined with dezocine can be an effective way of improving postoperative analgesia and inhibiting the stress reaction and inflammatory response after laparoscopic cholecystectomy,which provides a good theoretical basis for the better clinical application.Methods:Ninety cases of laparoscopic cholecystectomy under the general anesthesia are selected.ASA ?-?,aged 20-65 years old,BMI 18.5-28.0Kg/m2 and randomly divided into three groups(n=30):group DZ(dezocine group)?group TAP(transversus abdominis plane block group)?group TAP+DZ(transversus abdominis plane block combined with dezocine group).All the three groups were induced by rapid induction of tracheal intubation,group DZ was given 0.1mg/kg dezocine 30 minutes before the end of the operation,group TAP was used B-ultrasonic guidance to find bilateral rib arch to staring transversus abdominis plane block and 0.25%ropivacaine for each 20ml after induction of anesthesia,and group TAP+DZ was the same like B-ultrasonic guidance under bilateral costal arch transversus abdominis plane block,0.25%ropivacaine for each 20ml,and given 0.1mg/kg dezocine 30 minutes before the end of the operation.systolic blood pressure(SBP)and diastolic blood pressure(DBP),heart rate(HR)were recorded before anesthesia(T0,after entrancing into the operative room and calm for 10 min),5 min after endotracheal intubation(T1),5 min after skin incision(T2),5 min after the establishment of artificial pneumoperitoneum(T3),at the end of operation(T4),24 hours after operation(T5)at all time points were recorded;It also records the total dosage consumption of propofol and remifentanil in the operation,and the timing of operation,blood loss;The Resting VAS score of 30min,6h,12h,24h and 48h in three group were statistically analyzed;The peripheral venous blood 5ml was extracted at three time points of T0,T4 and T5.The specimens were centrifuged immediately after collection.The supernatant was stored in the refrigerator at-20?for examination.The levels of CRP and IL-6 in the serum of the three groups were recorded and at the time of point T0,T4 and T5.Results:Compared with those group DZ,The SBP.DBP and HR in group TAP and group TAP+DZ are lower than those of group DZ at the time of T2?T3?T4?T5(P<0.05).Compared with those group TAP,The SBP?DBP and HR in group TAP+DZ are lower than group TAP at the time of T4?T5(P<0.05);Compared with those group DZ,the total dosage consumption of propofol and remifentanil are lower in group TAP and group TAP+DZ(P<0.05);Compared with those group DZ,The Resting VAS scores in group TAP and group TAP+DZ are lower than those in group DZ after 30mins,6h,12h and 24h after post operation(P<0.05),Compared with those group TAP,The Resting VAS scores in group TAP+DZ are lower than those in group TAP after 30mins,6h after post operation(P<0.05);Compared with group TAP and group TAP+DZ,the level of serum CRP and IL-6 at T4 and T5 time points,which was significantly lower than that in group DZ,and group TAP+DZ was the lowest level(P<0.05).Conclusion:In laparoscopic cholecystectomy,transabdominal transverse block combined with dezocin can maintain stable hemodynamics,reduce the dosage of total anesthetic,improve postoperative analgesic effect,reduce the release of inflammatory factors and protect the body,which can be used as one of the choice of postoperative multimode analgesia.