WITHDRAWN: Efficacy of Dexmedetomidine as an Adjunct to Ropivacaine in Bilateral Dual-Transversus Abdominis Plane Blocks in Patients with Ovarian Cancer Underwent Cytoreductive Surgery

Abstract

Objective: To evaluate the postoperative control of pain and recovery in patients with ovarian cancer underwent cytoreductive surgery by adding dexmedetomidine to ropivacaine in bilateral dual-transversus abdominis plane (Bd-TAP) blocks.Methods: We enrolled ninety ASA I-III patients undergoing open abdominal cytoreductive surgery in this study. Patients were randomized assigned into three groups (TAP-R, TAP-DR, and CON, n=30 in each). All patients received standardized general anesthesia and postoperative Bd-TAP blocks were performed. The TAP-R, TAP-DR and CON group received Bd-TAP blocks with 0.3% ropivacaine, 0.3% ropivacaine and dexmedetomidine 0.5µg/kg, and 0.9% normal saline, respectively. All patients received patient-controlled intravenous analgesia (PCIA). The first request time for PCIA bolus, the VAS scores at 0, 6, 12, 24, and 48 hours after operation, the cumulative sufentanil consumption in 24 and 48 hours were compared. Pulmonary function was evaluated pre-operation and 24h after operation. The use of rescue drugs, early recovery quality was recorded.Results: Median values of the first request time for PCIA in the TAP-DR was 13.5 (11.0-16.0) hours, which was significantly longer than those in the TAP-R and CON groups [7.0 (6.0-9.0) and 3.0 (1.0-4.5)]. The VAS scores at rest and on coughing of TAP-DR group at all time points after operation were significantly lower than those of CON group (P <0.05). Cumulative sufentanil consumption in TAP-DR group were the least at 48h after surgery. Postoperative FEV1 and FEV1/FVC in TAP-DR group was significantly higher than group CON. Less rescue analgesics was needed by the patients in TAP-DR group (P <0.05). There was no significantly difference in the early recovery quality between TAP-DR and CON group (P >0.05).Conclusion: Dexmedetomidine combined with ropivacaine for Bd-TAP blocks prolonged the first bolus time of PCIA for ovarian cancer surgery and decreased sufentanil consumption. The procedure provided better postoperative analgesia and improved postoperative pulmonary function without excessive sedation.