Effect of transversus abdominis plane block combined with low-dose dexmedetomidine on elderly patients undergoing laparoscopic colectomy

腹横肌平面阻滞联合小剂量右美托咪定对老年患者行腹腔镜结肠切除术的影响

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Abstract

INTRODUCTION: Colon cancer is a common malignancy, for which surgery is currently the preferred therapy. AIM: To assess the effect of transversus abdominis plane block (TAPB) combined with low-dose dexmedetomidine on elderly patients undergoing laparoscopic colectomy. MATERIAL AND METHODS: Sixty-two elderly patients undergoing laparoscopic colectomy between March 2021 and March 2022 were randomly selected and equally divided into Group A (low-dose dexmedetomidine) and Group B (TAPB + low-dose dexmedetomidine) by the randomized double-blind method. The treatment outcomes were compared. RESULTS: The resting and active Visual Analogue Scale and Pittsburgh Sleep Quality Index scores were lower in Group B than those in Group A at 6 h, 1 day, 2 days and 3 days after operation (p < 0.05). The two groups had no significant differences in the levels of cluster of differentiation 4+ (CD4+), CD8+ and free Cor, CD4+/CD8+ ratio and NK cell level before anesthesia (p > 0.05). At 24 h after the operation, the level of CD4+, CD4+/CD8+ ratio and NK cell level were higher in Group B than those in Group A, and the levels of CD8+ and free Cor were lower in Group B (p < 0.05). Group B had higher partial pressure of oxygen ((45.52 ±11.14) mm Hg) and pH (7.42 ±0.06) (p < 0.05) and lower partial pressure of carbon dioxide ((4.05 ±0.32) mm Hg) than those of Group A (p < 0.05). CONCLUSIONS: TAPB combined with low-dose dexmedetomidine can exert better anesthetic, analgesic and sedative effects, and ameliorate stress responses.

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