A study on the application effect of dexmedetomidine combined with ropivacaine four-point nerve block on patients undergoing laparoscopic surgery of liver tumors
HUANG Liuqing
LU Liuyu
QIN Xiaotong
WANG Yonghao
KANG Xiaoyu
GONG Zheng
Abstract：Objective To explore the application effect of dexmedetomidine combined with ropivacaine four-point nerve block on laparoscopic surgery of liver tumors.Methods A total of 84 patients undergoing laparoscopic surgery of liver tumors under general anesthesia in the People's Hospital of Guangxi Zhuang Autonomous Region from August 2021 to July 2022 were selected and randomly divided into dexmedetomidine combined with ropivacaine group(group A,30 cases),ropivacaine group(group B,30 cases)and control group(group C,24 cases).Both group A and group B underwent ultrasound-guided four-point nerve block in the right low serratus anterior,right transversus abdominis plane below the rib margin,and bilateral posterior rectus sheath,and group C did not receive any nerve block.The hemo-dynamic changes at the time for intraoperative anesthesia(T,),5 minutes before skin incision(T2),5 minutes after skin incision(T3),at the time for hepatectomy(T4)and at the time for skin suture(T5),and the Visual Analogue Scale(VAS)scores at rest and in motion within 48 hours after surgery(2 hours,6 hours,12 hours,24 hours and 48 hours),the pressing times of the analgesic pump within 48 hours after surgery,and the occurrence of adverse reactions were compared among the three groups.Results At T1-T5 time points,the levels of mean arterial pressure(MAP)and heart rate(HR)showed a trend of first increasing and then decreasing in the three groups,and there were no statistically significant differences in the two indicators at different time points between groups(P＞0.05).The VAS scores at rest showed a trend of first increasing and then decreasing in the three groups after surgery.The VAS scores at rest in group B and group C were significantly higher than those in group A at 6 hours,12 hours and 24 hours after surgery(P＜0.05).The VAS scores at rest in group B were still significantly higher than those in group A at 48 hours after surgery,but there were no statistically significant differences between group A and group C(P＞0.05).The VAS scores in motion showed a trend of first increasing and then decreasing in the three groups after surgery.The VAS scores in motion in group C were significantly higher than those in group A at 2 hours,6 hours and 48 hours after surgery(P＜0.05).The VAS scores in motion in group B were significantly higher than those in group A only at 6 hours after surgery(P＜0.05).Compared with group C,both group A and group B showed a significant reduction in the pressing times of the analgesic pump(P＜0.05).There were no statistically significant differences in the first exhaust time,recovery time of diet,time of getting out of bed for the first time and hospitalization time among the three groups(P＞0.05).There were statistically significant differences in the total incidence rate of postoperative adverse reactions and nerve block-related complications among the three groups(P＜0.05).Conclusion Dexmedetomidine combined with ropivacaine four-point nerve block for laparoscopic surgery of liver tumors under general anesthesia has no significant differences in hemodynamic effects at various time points during the operation,but it improves postoperative upper abdominal analgesia,reduces the pressing times of the analgesic pump,and has no obvious adverse reactions,which is worthy of promotion.
Keywords：DexmedetomidineRopivacaineAbdominal nerve blockLow serratus anterior plane blockMultimodal analgesiaLaparoscopySurgery of liver tumor
Publication Date：2024-04-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 371-377 )