Application of Different Doses of Dexmedetomidine Combined with Ropivacaine for TAP Block in Laparoscopic Myomectomy/ZHUJia，SUJing，CAO Saihong.//Medical Innovationof China，2025，22（16）： 112-116

[Abstract]Objective：To observe the effects of different doses of Dexmedetomidine combined with Ropivacaine for transversus abdominis plane （TAP） block on postoperative pain and postoperative recovery quality in patients undergoing laparoscopic myomectomy.Method： One hundred and two patients who were admitted to the Shangrao Municipal Hospital from July 2O22 to December 2O23 and planned to undergo laparoscopic myomectomy were selected as the subjects. Theywere divided into groupA（ n： =34），groupB（ n= 34）and group C（ n =34）using the random number table method.All patients underwent conventional endotracheal intubation and general anesthesia. At the end of the operation，different doses （0.3 μg/μ g， 0.5μg/kg and 0.7μg/kg ofDexmedetomidine combined with 20mL of 0.375% Ropivacaine Injection were given for TAP block.Visual analogue scale（VAS） scores in restingstateat6h，24hand48haftersurgery，intraoperativebloodlos，postoperativerecoveryindicators （first ventilation time，gastrointestinal functionrecoverytime，time toof-bedactivityandlengthof hospital stay），and anesthesia recovery quality[15-item quality of recovery （QoR-15） scale] on 1， d after surgery were recorded. Result：The VAS scores at 6，24，and 48 hours after operation in group B and group C were significantly lower than those in group A（ P- lt;0.05）. The first ventilation time，gastrointestinal function recovery time，and time to offbedactivity in groupBand groupC were earlier thanthose ingroup A，and length of hospital staywasshorter than that in group A （ P lt;0.05）.However，there were no statistical differences in VAS scores and postoperative recovery indexesbetween group B and group C at the above time points （ Pgt;0.05 ），and there wasnosignificant difference inintraoperative blood loss among the three groups（ Pgt;0.05 ）.QoR-15 scale scoresof group B and group C were significantly higher than those of group A on1d and2d after surgery （ P lt;0.05），however， there were no statistical differences in QoR-15 scale scores between group B and group C （ P_- gt;0.05）. The total incidence of adverse reactions in group A，group B and group C were 11.76% ， 8.82% and 14.71% ，without statistically significant difference 1 Pgt;0.05 ）. Conclusion： Moderate dose （0.5μg/kg） of Dexmedetomidine combined with Ropivacaine for TAP block has ideal analgesic efect in laparoscopic myomectomy，and itcan accelerate postoperative recovery and improve the quality of anesthesia recovery，and is safe.

[Key words] Dexmedetomidine Transversus abdominis plane block Laparoscopic myomectomy Analgesic effectPostoperative recovery quality

First-author'saddress：Department of Anesthesia，Shangrao Municipal Hospital，Shangrao 334000 nina

doi：10.3969/j.issn.1674-4985.2025.16.027

子宫肌瘤属于一种因子宫平滑肌增生所致的多发性良性病变，通常在育龄期妇女中发现，尤其是40岁以上的女性。具体造成子宫肌瘤的原因仍不完全清楚，但雌激素水平增加可能与其生长有关，大部分患者无症状，部分患者以腹痛、出血、月经异常等症状为主，严重者可出现流产、不孕不育[-2]。临床上关于子宫肌瘤的治疗方案以手术切除为主流方案，腹腔镜剔除术较传统的切除方式切口更小，且腹腔镜下手术可以更精准的确认肌瘤位置，减少损伤健康组织，因此手术过程中的出血量通常较少，疼痛较轻，可缩短患者住院时间[3-4]。术前麻醉是手术实施的关键一环，良好的麻醉可以保证手术的顺利进行，同时加快患者术后恢复，右美托咪定是一种强效的合成阿片类镇痛药，因其起效快，持续时间短，镇痛、镇静效果好，被广泛运用于全身麻醉、术中的镇痛管理与直肠镜检查等场景中[5-6]。腹横肌平面（TAP）阻滞是一种神经阻滞技术，主要用于控制腹部疼痛，该技术使用局部麻醉药在腹肌内进行注射，以阻断传递疼痛信号的神经，较传统口服镇痛药物，其兼具有作用迅速、镇痛效应突出、副作用少等多项优点，近年来在临床应用较为广泛[7-8]。目前对于腹腔镜子宫肌瘤剔除术患者TAP阻滞过程中右美托咪定的使用剂量尚未有固定标准，遂取上饶市立医院近期择期拟行腹腔镜剔除术的子宫肌瘤患者，予以不同剂量右美托咪定复合罗哌卡因行TAP阻滞，意在明确右美托咪定的合适剂量，探求更为安全、有效、经济的手术麻醉方案。……