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| Analgesic effect of three concentrations of ropivacaine used in erector spinae plane block during the laparoscopic total hysterectomy |
| 1. Xuancheng Central Hospital, Xuancheng, Anhui Province, 242000；2. Anqing First People's Hospital, Anqing, Anhui Province |
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Abstract To investigate the analgesic effect of three concentrations of ropivacainw used in erector spinae plane block (ESPB) during the laparoscopic total hysterectomy. Methods: A total of 153 patients who wanted laparoscopic total hysterectomy were included and were randomly divided into group A (51 cases with 0.25% ropivacaine for analgesis), group B (51 cases with 0.375% ropivacaine for analgesis), and group C (51 cases with 0.5% Ropivacaine for analgesis) between March 2020 and March 2022. The time of operation, the amount of bleeding during operation, the dose of sufentanil infusion, the times of pressing analgesia pump, the visual analogue scale (VAS) score, the values of mean arterial blood pressure (MAP) and heart rate (HR), the time to eye opening, the agitation score, the Ramsay sedation score, and the side effects rate of the patients were compared among the three groups. Results: Repeated measures ANOVA showed that the VAS score, the time effect of MAP, the intergroup effect, and the interaction between time and grouping, the time effect of HR, and the intergroup effect of the patients had significant differences among the three groups (all P<0.05), while the interaction between time and grouping of the patients had no significant difference (P>0.05). The pairwise comparison showed that the VAS score of the patients in group B at 2h, 8h, 12h, 24h, or 48h after surgery was significantly lower than that of the patients in group A, but which was significantly higher than that of the patients in group C. The values of MAP and HR of the patients in group B at 30min after surgery or at the end of surgery was significantly lower than that of the patients in group A, but which was significantly higher than that of the patients in group C. The dose of sufentanil infusion of the patients in group A and in group B was significantly higher than that of the patients in group C. The number of pressing the analgesic pump of the patients in group B was significantly less than that of the patients in group A, but which of the patients in group B was significantly more than that of the patients in group C. The sensory block plane of the patients in group A was significantly higher than that of the patients in group B and in group C (all P<0.05). The time to eye opening, the agitation score, and the Ramsay sedation score of the patients in group B were significantly lower than those of the patients in group C, the agitation score of the patients in group B was significantly lower than that of the patients in group A, and the Ramsay sedation score of the patients in group B was significantly higher than that of the patients in group A (all P<0.05). The total incidence of adverse reactions of the patients in group A and in group B was significantly lower than that of the patients in group C (P<0.05). Conclusion: 0.375% ropivacaine used in ESPB of the patients during laparoscopic total hysterectomy has better analgesic effect.
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