Effect of transversus abdominis plane block with combination of dexmedetomidine and ropivacaine on prolactin levels and postoperative analgesia after caesarean section

Abstract

Objective To observe the effect of transversus abdominis plane block(TAPB) with combination of dexmedetomidine(Dex) and ropivacaine on prolactin(PRL) levels and postoperative analgesia after caesarean section. Methods Fifty patients(20-40 years old, ASA ⅠorⅡ) subjected to cesarean section under spinal cord anesthesia were randomly divided into two groups(A and B, 25 patients in each group). All patients received bilateral TAPB with ropivacaine(0.33%, 30 ml) under the guidance of ultrasound immediately after caesarean section. Patients in group B, but not group A, received additional 0.75 g/kg Dex. The time for colostrum production, and occurrence of postoperative nausea and vomiting(PONV), respiration depression, and dizziness were recorded. The levels of prolactin before and after surgery were measured. VAS at rest and during activity were assessed 6, 12, 24, 48 h after the operation. Results The time for colostrum production was earlier in group B than group A(P 0.05). However, the VAS scores were higher in group A(P<0.05). VAS scores during activity 6, 12, 24, 48 h after the operation were lower in group B than in group A(P<0.05). The incidences of PONV and dizziness 6, 12, 24, 48 h after the operation were significantly decreased in group B, compared with group A(P<0.05). Conclusions TAPB with the combination of 0.75 g/kg Dex and 0.33% ropivacaine after caesarean section can promote early lactation, maintain maternal analgesia effect, and minimize adverse reactions. Key words: Transversus abdominis plane block; Caesarean section; Prolactin; Analgesia