右美托咪定联合腹横肌平面阻滞用于结直肠癌手术的镇痛效果及对术后认知障碍的影响OA

Objective To explore the analgesic effect of dexmedetomidine(Dex)combined with transver-sus abdominis plane block(TAPB)during surgery and its influence on postoperative cognitive dysfunction(POCD)in patients with colorectal cancer(CRC).Methods A total of 92 CRC patients admitted to our hospital from January 2023 to December 2024 were randomly divided into the control group and the observation group,with 46 cases in each group.The control group received single TAPB anesthesia,while the observation group was given combined anesthesia of TAPB and Dex.The analgesic effect,stress indicators including nor-epinephrine(NE),epinephrine(E)and cortisol(COR),cognitive function,incidence of POCD,patient-controlled analgesia pump usage and adverse reactions were compared between the two groups.Results The Visual Analogue Scale(VAS)scores of the observation group at 2 h,6 h,12 h and 24 h after surgery were significantly lower than those of the control group(P<0.05).The levels of NE,E and COR at 24 h after surgery in the observation group were lower than those in the control group(P<0.05).Three days after sur-gery,the Mini-Mental State Examination(MMSE)score of the observation group was higher,while the inci-dence of POCD was lower than that of the control group(P<0.05).Compared with the control group,the observation group had longer time to the first postoperative analgesia pump pressing,fewer total pressing times and lower incidence of adverse reactions(P<0.05).Conclusion Compared with single TAPB,Dex com-bined with TAPB presents better perioperative analgesic efficacy for CRC surgery.It can relieve perioperative stress response,reduce the occurrence of adverse reactions and POCD with reliable clinical safety,which is con-ducive to optimizing the perioperative anesthesia scheme for CRC patients.