Objective To observe the effect of ultrasound guided transversus abdominis plane block of ropivacaine with different concentrations in laparoscopic radical resection of rectal cancer in elderly patients with postoperative analgesia.
Methods The clinical data of 90 elderly patients treated in our hospital from January,2013 to January,2017 which underwent laparoscopic radical resection of rectal cancer were enrolled in the study. According to anesthesia method they were divided into three groups,all in the induction of general anesthesia after ultrasound-guided bilateral transversus abdominis plane block.A,B,C three groups were injected with 0.10%,0.25%,0.50% ropivacaine hydrochloride 25 ml; postoperative intravenous analgesia pump:sufentanil 0.8 g/kg+ondansetron 16 mg+butorphanol 10 mg saline configured for 100 ml,set the background dose of 2 ml/h.Controlled time 15 min,self-control dose 2 ml.The two groups were observed mean arterial pressure(MAP) and heart rate(HR) level changes Before anesthesia(T0),1 h after surgery(T1),12 h after surgery(T2),24 h after surgery(T3)and 48 h(T4) after surgery; visual analogue score were compared between the three groups after operation(VAS score) were recorded after 24 h; The use of sufentanil analgesia pressing times and total; adverse reactions were compared between the three groups.
Results Group A MAP and HR at 1 h after surgery(T1),12 h after surgery(T2),24 h after surgery were higher than group B,group C and group A MAP and HR at T1,T2,T3 were higher than that of T0 moment(
P<0.05);group B MAP,HR at T1 were higher than that of group C(
P<0.05),group B had more stable hemodynamics.Group A VAS scores at T1,T2,T3,T4 time were lower than the group B,group C(
P<0.05),and there was no significant difference in VAS score between group C and group B(
P>0.05);Group A 24 h analgesia the presses of the pump and the total sufentanil were higher than B group,C group(
P<0.05);the incidence of complications in group C was higher than that of group A and group B(
P<0.05).
Conclusion Ultrasound guided transversus abdominis plane block with 0.25% ropivacaine used in laparoscopic radical resection of rectal cancer patients with postoperative analgesia in the elderly is better,and the incidence of adverse reactions is low.
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