Abstract

This study aimed to investigate the impact of adding dexmedetomidine to ropivacaine in patients undergoing laparoscopic myomectomy on pain control, comfort levels, stress markers, and sleep quality. 96 patients undergoing laparoscopic myomectomy were randomly assigned to receive either ropivacaine alone or ropivacaine combined with dexmedetomidine for transversus abdominis plane block. General anesthesia was administered using standardized protocols. Blood samples were collected before nerve blockade (T0) and postoperatively at 1 h (T1) and 24 h (T24) for quantification of stress markers. Pain scores were assessed using the visual analogue scale. Comfort levels were evaluated using the general comfort questionnaire and perianesthesia comfort scale. Sleep quality was assessed using the numeric rating scale and Athens insomnia scale on 1st and 3rd d post operation. Visual analogue scale scores showed significant differences between the groups at T1 and T24, with lower scores observed in the ropivacaine+dexmedetomidine group. General comfort questionnaire scores were significantly higher in the ropivacaine+dexmedetomidine group at both T1 and T24 compared to the ropivacaine group. Levels of cortisol, norepinephrine, interleukin-6, interleukin-1 beta, and tumor necrosis factor-alpha, were lower in the ropivacaine+dexmedetomidine group compared to the ropivacaine group. Patients receiving ropivacaine combined with dexmedetomidine demonstrated improved sleep quality on 1st and 3rd d of post operation. compared to those receiving ropivacaine alone. Adding dexmedetomidine to ropivacaine for transversus abdominis plane block in laparoscopic myomectomy patients resulted in improved pain control, comfort levels, stress reduction and sleep quality, suggesting potential benefits for perioperative management.