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Abstract To explore the analgesia effect of transversus abdominis plane block (TAPB) with the combined dexamethasone, dexmedetomidine and ropivacaine for puerperae after cesarean section. Methods: A total of 80 puerperae who had undergone cesarean section in the hospital were enrolled as the research objects between April 2021 and April 2023. After the surgery, all the puerperae were given ultrasound-guided bilateral TAPB for analgesia. According to the random number table method, these puerperae were divided into group D (40 cases with dexmedetomidine combined with ropivacaine for TAPB) and group S (40 cases with dexamethasone combined with ropivacaine for TAPB). The time of getting out of bed, the hospitalization stay, the time of the first analgesic pump compression, the number of the analgesic pump effective compression within postoperative 24h, the cumulative dosage of sufentanil, the maternal satisfaction, the scores of visual analogue scale (VAS) under rest/exercise state and the quality of recovery 40 questionnaire (QoR40) score, and the incidence of adverse reactions of the puerperae were compared between the two groups. Results: The time of getting out of bed (7.71±0.86 h), the duration of hospital stay (5.39±0.41d), the number of effective pressing analgesia pump within postoperative 24h (2.01±1.31 times) and the cumulative dosage of sufentanil used within postoperative (46.39±0.72μg) of the puerperae in group S were significantly lower than those (8.93±1.15h, 6.05±0.72d, 2.73±1.62 times and 48.33±0.63μg) of the puerperae in group D. The first analgesic pump pressing time (689.72±68.17min) and the maternal satisfaction (8.11±0.87) of the puerperae in group S were significantly higher than those (552.63±52.15min and 6.33±1.23) of the puerperae in group D. At 6h, 12h, 24h and 48h after operation, the VAS scores under rest/exercise state of the puerperae in group S at postoperative 6h, 12h, 24h and 48h were significantly lower than those of the puerperae in group D. The scores of comfort, emotion, self-care ability, social interaction, pain and QoR-40 of the puerperae in group S were significantly higher than those of the puerperae in group D. The total QoR-40 score (169.52±7.01 points) of the puerperae in group S was significantly higher than that (152.17±7.23) of the puerperae in group D (all P<0.05). There was no significant difference in the incidence of the adverse reactions of the puerperae between the two groups (P>0.05). Conclusion: Dexamethasone combined with ropivacaine for TAPB of the puerperae after cesarean section has better analgesia effect, which can effectively prolong the analgesia time, relieve the postoperative pain and improve the postoperative recovery quality of the puerperae, and with the better safety.
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