Application of Dexmedetomidine Combined with Transversus Abdominis Plane Block in Laparoscopic Surgery for Elderly Patients with Acute Abdomen

YANG Ming; ZHU Yongping

doi:10.13919/j.issn.2095～6274.ZHJY202504009

Abstract：Objective To investigate the application value of dexmedetomidine combined with transversus abdominis plane block(TAPB)in laparoscopic surgery for elderly patients with acute abdomen.Methods A retrospective study was conducted on 80 elderly patients with acute abdomen who underwent laparoscopic sur-gery at Pingtan Comprehensive Experimental Zone Hospital from September 2022 to December 2024.Based on the anesthesia protocol,patients were divided into two groups:the observation group(40 cases receiving dexme-detomidine+TAPB+general anesthesia)and the control group(40 cases receiving only general anesthesia).The two groups were compared in terms of anesthesia efficacy,postoperative pain level(VAS score),postoperative sedation(Ramsay score),cognitive function(MMSE score),recovery from anesthesia,and incidence of adverse events.Results Compared to the control group,the observation group exhibited a significantly shorter onset time of both motor and sensory blockade,as well as a significantly reduced time to reach the highest block level(P＜0.05).Additionally,the duration of motor blockade and sensory blockade was significantly prolonged in the observation group(P＜0.05).Patients in the obser-vation group also demonstrated significantly shorter recovery times,including time to awakening,time to regaining orientation,time to first flatus,time to resuming oral intake,and length of hospital stay(P＜0.05).Regarding postoperative pain,VAS scores at 1 h,6 h,12 h,and 24 h after surgery were significantly lower in the observation group than in the control group(P＜0.05).In terms of se-dation,Ramsay scores at all postoperative time points were significantly higher in the observation group(P＜0.05),indicating a superior depth of sedation.Cognitive function assessment revealed that MMSE scores at 12 h and 24 h postoperatively were significantly higher in the observation group compared to the control group(P＜0.05).There was no statistically significant difference in the overall incidence of adverse events between the two groups(15.00％vs.7.50％,P＞0.05).Conclusion The combination of dexmedetomidine and TAPB for anesthesia in laparoscopic surgery for elderly patients with acute abdomen results in significant anesthesia efficacy,effective postoperative an-algesia and sedation,reduced incidence of postoperative cognitive dysfunction,faster recovery,and higher safety.