Background Perioperative Neurocognitive Disorders is a common neurological complication with no effective treatments after surgery. This research aims to evaluate the effect of transversus abdominis plane block with dexmedetomidine added to ropivacaine on the incidence of perioperative neurocognitive disorders in patients undergoing abdominal surgery and provides a new way to prevent it.
Methods 180 patients submitted to radical laparoscopic colorectal cancer surgery were randomly divided into Control Group（n=90） and Dex Group(n=90). Ultrasound guided transversus abdominis plane block was performed after anesthesia induction: 0.5% ropivacaine 20ml was injected into each transversus abdominis plane in Control Group, 0.5% ropivacaine + 1μg/kg dexmedetomidine (add up to 20ml) in Dex Group. Primary indicators were the incidence of perioperative neurocognitive disorders within 30days after surgery. Secondary indicators were the duration of operation and anesthesia, consumption of general anesthetics, fluid intake, urine and blood loss during operation, visual analog pain scores.
Results 169 cases were finally analyzed, including 84 in Control Group and 85 in Dex Group. The consumption of propofol and remifentanil in Dex Group was lower than that in Control Group ((0.82±0.33) g vs. (1.22±0.42) g，(1.17±0.40) mg vs. (1.48±0.60) mg, P<0.05). There was no significant difference in visual analog pain scores between the two groups at 3days and 7days after surgery (P>0.05), while lower than Control Group at 6 hours and 24 hours after surgery. In terms of the incidence of perioperative neurocognitive disorders, compared with Control Group, there was no significant differences at 3days and 7days (P>0.05), but significantly decreased at 6hours, 24days and 30days after surgery (7.1% vs.17.9%，4.7% vs.14.3%，3.5% vs. 11.9%，P<0.05) in Dex Group.
Conclusion While conducting transversus abdominis plane block after general anesthesia induction, dexmedetomidine added to ropivacaine for it can reduce the incidence of perioperative neurocognitive disorders within 30days after surgery，which may be related to reduce the consumption of general anesthetics and provide satisfactory postoperative analgesia.
Trial registration: Dexmedetomidine Added to Ropivacaine for Transversus Abdominis Plane Block Reduces the Incidence of Perioperative Neurocognitive Disorders：a single centre randomized controlled trial, ChiCTR2100046876. Registered 29 May 2021, https://www.chictr.org.cn/edit.aspx?pid=125579&htm=4.