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| Effects of dexmedetomidine combined with ropivacaine for quadratus lumborum block during laparoscopic myomectomy of patients on their stress and postoperative recovery |
| 1. Postgraduate Training Base of Jinzhou Medical University (Jincheng People's Hospital of Shanxi Province), Jincheng, Shanxi Province, 048026; 2. The Eighth People's Hospital of Hengshui, Hebei Province |
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Abstract To investigate the effects of dexmedetomidine combined with ropivacaine for quadratus lumborum block (QLB) during laparoscopic myomectomy (LM) of patients on their stress and postoperative recovery. Methods: 80 patients who wanted LM admitted to the obstetrics and gynecology department of the hospital were randomly divided into group A and group B (40 patients in each group) from January 2023 to December 2023. The patients in group A were given ropivacaine for QLB, while the patients in group B given dexmedetomidine combined with ropivacaine for QLB. The postoperative pain evaluated by VAS score, the levels of stress response indicatiors, such as cortisol and norepinephrine, the cognitive function evaluated by MMSE score, the sleep quality evaluated by PSQI score, the time of postoperative recovery, such as the exhaust time, the time of getting out of bed and the duration of hospitalization stay, and the situation of adverse reactions, such as nausea and vomiting, dizziness, drowsiness and itching, of the patients in the two groups were observed. Results: The VAS scores of the patients in group B at 2h, 6h, 12h and 24h after operation (1.02±0.24 points, 1.63±0.48 points, 2.01±0.72 points and 3.06±0.70 points) were significantly lower than those (1.15±0.36 points, 1.95±0.60 points, 2.62±0.85 points and 3.77±0.76 points) of the patients in group A. The levels of cortisol and norepinephrine of the patients in both groups at 24 hours after operation had increased significantly, but which (165.17±48.25 ng/ml and 322.15±53.83 ng/L) of the patients in group B were significantly lower than those (189.25±51.03 ng/ml and 345.23±45.90 ng/L) of the patients in group A. The MMSE score of the patients in both groups at 24 hours after operation had decreased significantly and the PSQI score of the patients in both groups at 24 hours after operation had increased significantly, but the MMSE score (27.05±1.19 points) of the patients in group B was significantly higher than that (25.62±1.48 points) of the patients in group A and the PSQI score (16.23±1.56 points) of the patients in group B was significantly lower than that (18.00±1.68 points) of the patients in group A. The time of the postoperative exhaust (25.86±5.12 h), the time of getting out of bed (1.88±0.69 d) or the duration of hospital stay (6.01±1.60 d) of the patients in group B was significantly shorter than that (33.57±6.34 h, 2.65±0.75 d or 7.32±1.78 d) of the patients in group A (all P<0.05). There was no significant difference in the incidence of the adverse reactions (15.0% vs. 12.5%) of the patients between the two groups (P>0.05). Conclusion: The combination of dexmedetomidine and ropivacaine for QLB during LM of the patients has better anesthetic effect, and can reduce the postoperative pain and stress reactions, improve the cognitive function and the sleep quality of the patients, and which is beneficial for the postoperative recovery with the safety of medicine.
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