Analgesic Efficacy of Dexamethasone as an Adjunct to Levobupivacaine for Transverse Abdominal Plane (Tap) Block After Cesarean Section
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Abstract
Background: When performing various nerve block procedures, several adjuvants have been utilized to enhance the effectiveness and lengthen the duration of local anesthetics. The purpose of the current study was to determine how adding dexamethasone to levobupivacaine affected the effectiveness and duration of the transversus abdominis plane (TAP) block.
Material & Methods: A randomized trial was done in 60 patients undergoing
gynaecological laparoscopic surgery. All patients were randomized to two groups of 30 each.
Group 1 received Levobupivacaine with Normal saline and group 2 received Levobupivacaine with Dexamethasone 8mg.
Result: The maximum numbers of patients were between 20-30 years. Weight and height shows significant differences. Both the two groups experienced a gradual reduction in pain after the TAP block, as evidenced by VAS and the need of analgesics. The requirement for the first rescue analgesia was delayed in group II than group I, which was statistically significant with p–value <0.001.
Conclusion: In women scheduled for elective cesarean section, dexamethasone as an addition to levobupivacaine in the TAP block increases the duration until the first rescue analgesic request and decreases the overall amount of analgesic administered in the postoperative period.
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References
Prabhakar A, Mancuso KF, Owen CP, Lissauer J, Merritt CK, Urman RD, et al. Perioperative analgesia outcomes and strategies. Best Pract Res Clin Anaesthesiol2014;28:105-15.
Ramussen SB, Saied NN, Bowens C, Jr. Mercaldo ND, Schildcrout JS, Malchow RJ.Durationofupperandlowerextremityperipheralnerveblockadeisprolongedwith dexamethasonewhen addedtoropivacaine;aretrospectivedatabaseanalysis. PainMed(Malden,Mass)2013;14:1239-1247.
Cho S Kim YJ, Kim DY, Chung SS. Postoperative analgesic effects of ultrasound-guided trasversus abdominis plane block for open appendectomy. J Korean Surg Soc 2013;85:128-133
McDonnel JG, O’Donnel B, Curley G, Heffernan A, Power C, Laffey JG. The analgesic efficacy of transversus abdominis plane block after abdominal surgery; a prospective randomized controlled trial. AnesthAnalg2007;104:193-197.
Siddiqui MR, Sajid MS, Uncles DR, Cheek L, Baig MK. A meta-analysis on the clinical effectiveness of transversus abdominis plane block. J Clin Anesth2011;23:7-14.
Acharya R, Baksi R, Mohapatra P. Comparative analysis of duration of postoperative
analgesia between levobupivacaine and levobupivacaine with clonidine after ultrasound-
guided transversus abdominis plane block in patients undergoing lower segment cesarean
section. Anesth Essays Res. 2018;12(4):943–8.
Imani F, Zaman B, De Negri P. Postoperative pain management: Role of
dexmedetomidine as an adjuvant. Anesth Pain Med. 2021;10(6):e112176.
Xue Y, Yuan H, Chen Y. Effects of dexmedetomidine as an adjunct in transversus
abdominis plane block during gynecological laparoscopy. Exp Ther
Med. 2018;16(2):1131–6.
Kelly A. The minimum clinically significant difference in visual analogue scale pain score does not differ with severity of pain. Emergency Medicine Journal 2001; 18:205-207.
Moiniche, Steen MD; Jorgensen, Henrik MD; Wetterslev, Jorn MD, PhD; Dahl, Jorgen Berg MD, DMSc. Local Anesthetic Infiltration for Postoperative Pain Relief After Laparoscopy: A Qualitative and Quantitative Systematic Review of Intraperitoneal, Port-Site Infiltration and Mesosalpinx Block. Anesthesia & Analgesia: April 2000 ;90(4); 899-912.
Zhang D, Zhou C, Wei D, Ge L, Li Q (2019) Dexamethasone added to local anesthetics in ultrasound-guided transversus abdominis plain (TAP) block for analgesia after abdominal surgery: A systematic review and meta-analysis of randomized controlled trials. PLoS ONE 14(1): e0209646.
Petersen PL, Mathiesen O, Troup H, Dahl JB. The transversus abdominis plane block: A valuable option for post-operative analgesia? A topical review. Acta AnesthesiolScand2010;54:529-35.
Ammar AS, Mahmoud KM. Effect of adding dexamethasone to bupivacaine on transversus abdominis plane block for abdominal hysterectomy: A prospective randomized controlled trial. Saudi J Anaesth2012;6:229-33.
Chen Q, An R, Zhou J, Yang B (2018) Clinical analgesic efficacy of dexamethasone as a local anesthetic adjuvant for transversus abdominis plane (TAP) block: a meta-analysis. Plos One 13(6):e019892