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BACKGROUND Transversus Abdominis Plane Block (TAPB) is a newer regional anaesthesia technique which is commonly used now a days. It provides analgesia mainly after lower abdominal surgery where parietal wall pain is the major component of pain. Here sensory blockade of lower abdominal wall skin and muscles occur due to local anaesthetic deposition above transversus abdominis muscle. But it has been shown that it also useful in upper abdominal surgeries and retroperitoneal surgeries. We evaluated the effect of addition of dexmedetomidine to ropivacaine in TAP block in a single blind, and prospective, randomized controlled clinical trial. METHODS A total of 60 adult patients, 20 to 50 yrs. of age, of both sexes, ASA physical status I or II were randomized to Group R (n = 30) receiving TAP block with 20 ml of 0.375% ropivacaine and 2 ml of normal saline while Group RD (n = 30) received 0.5 mcg/Kg of dexmedetomidine diluted in normal saline to make 2 ml and 20 ml of 0.375% ropivacaine bilaterally followed by general anaesthesia. Hemodynamic responses to surgical incision were noted. Visual analog scale (VAS) scores were assessed on the emergence, then every 1 hr. up to 12 hrs. And at 24 hrs. Time to first rescue analgesic (when VAS ≥40 mm or on demand), duration of postoperative analgesia, incidence of postoperative nausea-vomiting were also noted. RESULTS Intraoperative heart rate decreases in group RD p<0.05). VAS score at 60-and 120min post-operatively was low in group RD (p<0.05). Duration of analgesia in group R (255.83 ± 51.96) less than group RD (405.33 ± 106.04) which is statistically significant. (p<0.05). No complication or side effect attributed to TAP block, local anaesthetic or dexmedetomidine were noted in any patient. CONCLUSIONS Addition of dexmedetomidine improves quality and duration of analgesia in laparoscopic cholecystectomy patients when used as adjuvant to ropivacaine in TAP block.

Background: Modern laparoscopic surgeries with insufflation of gas into peritoneal cavity are gold standard treatment for cholelithiasis. Propofol, a GABA receptor positive allosteric modulator and Sevoflurane, an inhalational anesthetic are used for maintenance of general anesthesia. In laparoscopy, significant hemodynamic changes occur. Searching in field of anesthesia is going on for anesthetic agent for better recovery. Aims and Objectives: Objective of the study is to compare sevoflurane with propofol for intraoperative hemodynamic changes and post-operative recovery profile of patient’s undergone laparoscopic cholecystectomies under general anesthesia. Secondary objective is to compare post-operative complications. Materials and Methods: A prospective, randomized, single-blinded, and comparative study done after permission from the institutional ethical committee and informed consent from patients. Total 84 patients of 20–50 years age of either sex were scheduled for laparoscopic cholecystectomy, divided in two equal groups – Group P, induced with propofol and anesthesia was maintained with propofol (100–120 μg/kg/min), nitrous oxide and oxygen and Group S induced with propofol and anesthesia was maintained using sevoflurane (1–2%), nitrous oxide, and oxygen. Results: We found that time for eye opening was 9±1.21 min in Group P and 8±1.34 min in Group S. Time for following verbal command was 10±1.20 min in Group P and 9±1.32 min in Group S. Time for speaking name by patient was 11±1.20 min in Group P and 10±1.34 min in Group S. Difference between two groups regarding eye opening, following verbal command, and time to speak own name are highly significant with P<0.001 which proves that eye opening, following verbal command and time for speaking name by patient were significantly shorter in sevoflurane group. Time to achieve modified aldrete score >8 was 14±1.30 min in Group P and 13±1.37 min in Group S. Difference between two groups is also highly significant with P<0.001 which proves that time to achieve modified aldrete score>8 were significantly shorter in sevoflurane group. Conclusion: From our study, maintenance of general anesthesia with sevoflurane is associated with faster recovery from anesthesia.

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