Abstract： Objective:To investigate the effects of dexmedetomidine combined with ropivacaine for transversus abdominis plane (TAP) block on analgesia following total laparoscopic hysterectomy.Methods:A total of 101 patients who underwent total laparoscopic hysterectomy in Hunan Maternal and Child Health Hospital between June 2018 and June 2020 were included and divided into the study group ( n=51) and control group ( n=50) according to the random number table. The two groups underwent surgery with general anesthesia and conventional endotracheal intubation. After surgery, ultrasound-guided bilateral TAP block was performed. The study group was given analgesia with ropivacaine+ dexmedetomidine, while the control group was given ropivacaine alone. All patients received patient-controlled intravenous analgesia (PCIA) after surgery. Numerical rating scale (NRS) and Ramsay sedation score at rest or with activities were compared between the two groups at different time points postoperatively. The time to the first pressing of the analgesic pump, the number of analgesic pump pressing within 48 h after surgery, the rate of remedial analgesia, the time to recovery of gastrointestinal function and the time to ambulation were compared between the two groups. Adverse reactions and complications related to TAP block within 48 hours after surgery were recorded. Results:At 2 h, 6 h, and 12 h after surgery, the study group showed lower NRS scores and higher Ramsay scores at rest or with activities than those in the control group (all P<0.05) . There was no statistically significant difference in NRS scores between the two groups at rest or with activities at 24 h and 48 h after surgery (all P>0.05) . Compared with the control group, the study group showed significantly longer time to first pressing of the analgesic pump after surgery, fewer number of analgesic pump pressing within 48 h after surgery, and lower rate of remedial analgesia (all P<0.05) . The incidence of adverse reactions in the study and control groups were 17.6% (9/51) and 42.0% (21/50) , respectively, with significantly lower rate in the study group than that in the control group ( χ2=7.171, P<0.05) . There was no significant difference in the incidence of TAP block-related complications between the two groups ( P>0.05) . Conclusion:Dexmedetomidine combined with ropivacaine for TAP block can enhance and effectively prolong the analgesic effect after surgery.