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目的:研究腹横肌平面阻滞联合右美托咪啶对全身麻醉(全麻)剖宫产术后苏醒质量的影响。方法:选择2019年6月至2020年9月长沙市妇幼保健院收治的120例全麻剖宫产产妇,随机数字表法分为右美托咪啶组(D组),腹横肌平面阻滞组(T组),腹横肌平面阻滞联合右美托咪啶(TD组)和对照组(C组)。所有产妇切口处行1%利多卡因局部浸润,采用丙泊酚和罗库溴铵全麻诱导,剖出胎儿后,静脉输注舒芬太尼和咪达唑仑,泵注丙泊酚维持麻醉。同时D组和TD组泵注右美托咪啶,T组和C组泵注生理盐水。T组和TD组缝合腹直肌后鞘后,放置细导管至两侧腹横肌筋膜处,各注入0.33%罗哌卡因10 ml。术毕送麻醉复苏室(PACU)。记录术毕至拔除气管导管的时间,记录术前(Tn 1)、诱导后(Tn 2)、术毕(Tn 3)、拔管时(Tn 4)、拔管后10min(Tn 5)及出PACU时(Tn 6)六个时间点的HR、平均动脉压(MAP),记录Tn 4、Tn 5、Tn 6时的Steward苏醒评分,记录拔管时躁动情况[镇静-躁动评分(SAS评分)]、PACU停留时间及疼痛VAS评分。n 结果:Tn 4、Tn 5、Tn 6时C组HR、MAP高于其他三组(n P0.05);术后TD组SAS评分[(4.0±0.4)分]最低,术毕至拔管时间[(10.1±1.5)min]和PACU停留时间[(21±4.2)min]最短(n P<0.05),术后TD组[(0.5±0.5)分]和T组[(1.1±0.4)分]VAS评分低于D组[(4.1±0.3)分]和C组[(5.3±0.5)分](n P0.05), while HR and MAP in group C at Tn 4, Tn 5 and Tn 6 were higher than those in the other three groups (n P0.05). The SAS score [(4.0±0.4)point], the time from the end of operation to extubation [(10.1±1.5)min] and stay time of PACU [(21±4.2)min] were the lowest in group TD than those in the other three groups (n P<0.05); the VAS score in group TD [(0.5±0.5)point] and group T [(1.1±0.4)point] were lower than that in group D [(4.1±0.3)point] and group C [(5.3±0.5)point] (n P<0.05).n Conclusions:The application of general anesthesia combined with TAPB and dexmedetomidine in cesarean section may improve the quality of anesthesia recovery.