Efficacy of transversus abdominis plane block with dexmedetomidine mixed with ropivacaine for postoperative analgesia in pediatric patients / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the efficacy of transversus abdominis plane (TAP) block with dexmedetomidine mixed with ropivacaine for postoperative analgesia in pediatric patients.Methods Forty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 1-4 yr,weighing 8-22 kg,scheduled for elective unilateral herniorrhaphy,were assigned into 2 groups (n=20 each) using a random number table method:ropivacaine group (group R) and dexmedetomidine mixed with ropivacaine group (group DR).TAP block was performed at the end of operation under ultrasound guidance,0.125％ ropivacaine 1 ml/kg was injected in group R and 0.075％ ropivacaine plus 1 μg/kg dexmedetomidine was injected in group DR.A dose of morphine 0.05 mg/kg was intravenously injected when Face Legs Activity Cry Consolability score ≥4.The duration of postoperative analgesia and consumption of morphine within 24 h after operation were recorded.The development of nausea and vomiting,bradycardia,hypotension,respiratory depression,over-sedation and TAP block-related complications (hematoma or infection at puncture site,peritoneal puncture,local anesthetic toxicity) within 24 h after operation were recorded.Results Compared with group R,the consumption of postoperative morphine within 24 h after operation was significantly reduced,and the duration of postoperative analgesia was prolonged in group DR (P ＜0.05).No hypotension,over-sedation or TAP block-related complications were found in two groups.There was no significant difference in the incidence of nausea and vomiting,respiratory depression or bradycardia after operation between two groups (P＞0.05).Conclusion Dexmedetomidine combined with ropivacaine provides better postoperative analgesic efficacy than ropivacaine alone when used for TAP block in pediatric patients.