Effect of ropivacaine combined with dexmedetomidine on onset and duration of transverse abdominis plane block / 上海交通大学学报（医学版）

ABSTRACT

Objective • To evaluate the effect of ropivacaine combined with dexmedetomidine on transverse abdominis plane (TAP) block guided by ultrasound and postoperative analgesia. Methods • A total of 180 patients (ASA grade I - II) undergoing laparoscopic ovarian cystectomy were randomly divided into control group (Con group) and dexmedetomidine group (Dex group). At the end of the operations, the patients were sent to the recovery rooms. After 10 minutes, TAP block was performed under the guidance of ultrasound, and morphine intravenous self-controlled analgesia pump was given for postoperative analgesia. The patients in Con group received TAP block with 40 mL of 0.375% ropivacaine. The patients in Dex group received 40 mL of 0.375% ropivacaine containing 100 μg dexmedetomidine. The onset time, duration of the sensory nerve block, delay of the first press of morphine pump, and total amount of morphine within 48 h after the operation and hemodynamic parameters were recorded. Results • The onset time in Dex group was earlier than that in Con group (P=0.032), and the duration of analgesia effect was also longer (P=0.012). The delay of first morphine pump press was also significantly later than that in Con group (P=0.008), and total morphine consumption significantly reduced within 48 h after operation (P=0.001). In terms of heart rate and mean arterial pressure, they were all lower in Dex group than those in Con group. Conclusion • Ropivacaine combined with dexmedetomidine can be safely and effectively used in TAP block. Compared with ropivacaine alone, the combination can maintain a longer sensory block, which can significantly reduce postoperative opioid usage.