Effect of Dexamethasone on Analgesic Effect of Transversal Plane Block in Patients Undergoing Laparoscopic Radical rResection of Colorectal Cancer
LIAO Chengqun
LI Zengqiang
ZHAN Yongkun
ZHANG Mengchao
HUANG Jianping
Abstract：Objective To investigate the analgesic effect of dexamethasone on transverse abdominal muscle plane block (TAPB) in patients undergoing laparoscopic radical resection for colorectal cancer.Methods 120 patients who underwent laparoscopic radical surgery for colorectal cancer admitted to Shaowu municipal hospital from May 2021 to March 2024 were se-lected as the study subjects.They were randomly divided into Group A,Group B,and Group C,with 40 patients in each group,using a random number table method.Among them,Group A only received general anesthesia,Group B received TAPB under ultrasound guidance after general anesthesia,and Group C received dexamethasone in addition to Group B.Com-pare three groups of perioperative indicators (remifentanil dosage,first rescue analgesic time,rescue analgesic drug dosage),analgesic effect (pain numerical scoring system (NRS) scores at different time points),inflammatory indicators[interleukin-6 (IL-6),tumor necrosis factor alpha (TNF-α)]stress indicators[cortisol (Cor),norepinephrine (NE),malondialdehyde (MDA)],and adverse reactions.Results The dosage of remifentanil and rescue analgesic drugs in Group A was higher than that in Group B and Group C,and the first rescue analgesic time was shorter than that in Group B and Group C,with statisti-cal significance (P<0.05) .There was no statistically significant difference in the dosage of remifentanil between Group B and Group C (P>0.05);The first rescue analgesia time in Group B was shorter than that in Group C,and the amount of res-cue analgesics used was higher than that in Group C,with a statistically significant difference (P<0.05).The NRS scores of Group A at 2 h,6 h 12 h,24 h,and 48 h after surgery were higher than those of Group B and Group C,and the difference was statistically significant (P<0.05).There was no statistically significant difference in NRS scores between Group B and Group C at 2 and 48 h after surgery (P>0.05);The NRS scores of Group B at 6 h,12 h,and 24 h after surgery were higher than those of Group C,and the difference was statistically significant (P<0.05).The serum levels of IL-6 and TNF-αshowed a trend of first increasing and then decreasing before and after surgery in the three groups.The serum levels of IL-6 and TNF-α at 6 h and 24 h after surgery were:Group A>Group B>Group C,and the difference was statistically significant (P<0.05).The serum levels of Cor,NE,and MDA before and after surgery in the three groups showed a trend of first in-creasing and then decreasing.The serum levels of Cor,NE,and MDA at 6h and 24h after surgery were:Group A>Group B>Group C,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in Group A,Group B,and Group C were,with no statistically significant difference (P>0.05).Conclusion Intravenous injection of dexam-ethasone (before anesthesia induction) and ultrasound-guided TAPB after general anesthesia can improve the analgesic effect of laparoscopic radical resection of colorectal cancer patients,reduce the consumption of opioids,and alleviate postoperative inflammatory and stress reactions.
Keywords：Laparoscopic radical resection of colorectal cancerDexamethasonePlane block of transverse abdominal muscleAnalgesic effectInflammatory response
Publication Date：2024-07-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 939-944 )