Effect of Ropivacaine Combined with Dexmedetomidine on the Analgesic Effect and Stress Hormone in Middle-Aged and Elderly Patients Undergoing Laparoscopic Radical Resection of Rectal Cancer
Objective To investigate the effect of combined ropivacaine and dexmedetomidine transversus abdominis plane block on pain and stress response after laparoscopic radical resection of rectal cancer in middle-aged and elderly patients.Methods Ninety patients scheduled for laparoscopic radical rectal cancer surgery at the First Affiliated Hospital of Xinxiang Medical University were selected.According to different medications for transversus abdominis plane block,patients were divided into group A,group B,and group C,with 30 cases in each group.Group A received bilateral transversus abdominis plane block with ropivacaine combined with dexmedetomidine,group B received bilateral transversus abdominis plane block with ropivacaine,group C did not undergo transversus abdominis plane block.Mean arterial pressure(MAP)and heart rate(HR)were recorded at the stable state upon entry to the operating room(T0),immediately after tracheal intubation(T,),30 minutes after pneumoperitoneum(T2),and 10 minutes after tracheal extubation(T3).The postoperative serum cortisol(Cor),norepinephrine(NE),and epinephrine(E)levels,resting visual analog scale(VAS)score,and Ramsay score were monitored.The number of postoperative analgesia pump presses,extubation time,and post-anesthesia care unit(PACU)dwell time were recorded.Results At time point T2,the MAP of group A patients was lower than that of group B and group C(P＜0.05).At time point T3,the MAP of group A patients was lower than that of group B and group C,and the MAP of group B was lower than that of group C(P＜0.05).At time points T2 and T3,the HR of group A patients was lower than that of group B and group C(P＜0.05).The extubation time and PACU retention time of patients in group A and group B were shorter than those in group C(P＜0.05).The number of postoperative analgesia pump presses in group A patients was less than that in group B and group C(P＜0.05),and group B was less than group C(P＜0.05).The resting VAS score and Ramsay score of group A and group B were lower than those of group C at 2 and 6 hours after surgery,and group A was lower than group B(P＜0.05).The resting VAS score of group A at 12 hours after surgery was lower than that of group B and group C(P＜0.05).At 2 and 12 hours post surgery,the NE,E,and COR levels in group A and group B were lower than those in group C,and group A was lower than group B(P＜0.05).There was no statistically difference in intraoperative hypotension,nausea and vomiting,chills,dizziness and headache among the three groups of patients(P＞0.05).Conclusion Combined use of ropivacaine and dexmedetomidine in transversus abdominis plane block effectively reduces postoperative pain and stress response in middle-aged and elderly patients undergoing laparoscopic radical rectal cancer surgery,improves postoperative analgesia,and enhances patient comfort.
dexmedetomidinestress responsetransversus abdominisplane block rectalcancer radical surgery
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