Effect of transverse abdominis plane block combined with dexmedetomidine on recovery quality after cesarean section under general anesthesia in post anesthesia recovery unit / 中国医师杂志

ABSTRACT

Objective:To study the effects of transverse abdominis plane block (TAPB) combined with dexmedetomidine on the recovery quality after general anesthesia in cesarean section.Methods:From June 2019 to October 2020, 120 cases of cesarean section in Changsha Maternal and Child Health Hospital were randomly divided into dexmedetomidine group (Group D), transversus abdominis plane block group (group T), transversus abdominis plane block combined with dexmedetomidine (Group TD) and control group (Group C). Before anesthesia induction, local infiltration of 1% lidocaine was performed at the incision of all parturients. Propofol and rocuronium were used for induction under general anesthesia. After delivery of fetus, sufentanil and midazolam were injected intravenously, and propofol was pumped to maintain anesthesia. At the same time, dexmedetomidine was pumped into group D and TD, and normal saline was pumped into group T and C. After the posterior sheath of rectus abdominis was sutured in T group and TD group, two epidural anesthesia catheters were placed to the fascia of transverse abdominis on both sides, and 10 ml of 0.33% ropivacaine was injected respectively. The parturients were sent to postanesthesia care unit (PACU) after the operation. The time from the end of operation to the extubation of tracheal tube, heart rate (HR) and mean arterial pressure (MAP) before operation (T 1), after induction (T 2), after operation (T 3), at the time of extubation (T 4), 10 minutes after extubation (T 5) and at the time of leaving PACU (T 6) were recorded. Steward's wake-up score at T 4, T 5 and T 6, agitation during extubation (Sedation Agitation Scale, SAS score), PACU stay time and pain visual analogue scale (VAS) were recorded. Results:There was no difference in HR and MAP between the four groups at T 1, T 2, and T 3 ( P>0.05), while HR and MAP in group C at T 4, T 5 and T 6 were higher than those in the other three groups ( P<0.05). There was no significant difference in Steward′s wake-up score among the four groups ( P>0.05). The SAS score [(4.0±0.4)point], the time from the end of operation to extubation [(10.1±1.5)min] and stay time of PACU [(21±4.2)min] were the lowest in group TD than those in the other three groups ( P<0.05); the VAS score in group TD [(0.5±0.5)point] and group T [(1.1±0.4)point] were lower than that in group D [(4.1±0.3)point] and group C [(5.3±0.5)point] ( P<0.05). Conclusions:The application of general anesthesia combined with TAPB and dexmedetomidine in cesarean section may improve the quality of anesthesia recovery.