Dexmedetomidine combined with ropivacaine in ultrasound-guided tranversus abdominis plane block improves postoperative analgesia and recovery following laparoscopic colectomy

Weizhong Pan; Guizhen Liu; Tao Li; Qiaoxia Sun; Meiru Jiang; Ganggang Liu; Jiahai Ma; Hong Liu

doi:10.3892/etm.2020.8508

Dexmedetomidine combined with ropivacaine in ultrasound-guided tranversus abdominis plane block improves postoperative analgesia and recovery following laparoscopic colectomy

Exp Ther Med. 2020 Apr;19(4):2535-2542. doi: 10.3892/etm.2020.8508. Epub 2020 Feb 10.

Authors

Weizhong Pan¹, Guizhen Liu², Tao Li¹, Qiaoxia Sun¹, Meiru Jiang¹, Ganggang Liu¹, Jiahai Ma¹, Hong Liu³

Affiliations

¹ Department of Anesthesiology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 264000, P.R. China.
² Department of Anesthesiology, Laiyang Central Hospital, Laiyang, Shandong 264000, P.R. China.
³ Department of Anesthesiology and Pain Medicine, University of California Davis Health, Sacramento, CA 95817, USA.

Abstract

The present prospective, double blind, randomized clinical study was designed to evaluate whether dexmedetomidine (Dex) combined with ropivacaine for tranversus abdominis plane (TAP) block could improve analgesic quality and duration, and promote recovery following laparoscopic colectomy. Following induction of anesthesia, ultrasound-guided bilateral TAP block was performed in 60 patients scheduled for elective laparoscopic colectomy with either 20 ml of 0.375% ropivacaine plus 2 ml normal saline 0.9% (R group), or 20 ml of 0.375% ropivacaine plus 2 ml Dex (0.5 µg/kg) (RD group). Visual analogue scale (VAS) score for pain, sedation level, length of hospital stay (LOS), and bowel function recovery time and associated complications were recorded. Overall patient satisfaction with postoperative pain management was also assessed. The hemodynamic variables were not significantly different between the two groups during the surgery. However, the duration of analgesia was significantly longer in the RD group compared with the R group (P<0.05). VAS scores at 1, 2, 6 and 12 h following surgery were significantly decreased in the RD group compared with those in the R group (P<0.05). There was no significant difference in sedation level between the two groups. Notably, postoperative nausea and vomiting in the RD group was significantly decreased compared with those in the R group in the first 24 h (P<0.05). There were no serious adverse events in any group. Furthermore, 90.0 and 66.7% patients were satisfied with the postoperative pain management in the RD group and R group, respectively. The postoperative first bowel movement time was significantly shorter in the RD group compared with the R group (P<0.05). However, the LOS was not significantly different between the two groups. In conlusion, the addition of Dex to ropivacaine could significantly improve the analgesic quality and duration of TAP block, which in turn promotes recovery following laparoscopic colectomy.

Keywords: colectomy; dexmedetomidine; ropivacaine; transversus abdominis plane.