Transversus abdominis plane block is facial plane block providing post-operative analgesia after lower abdominal surgeries as part of multi-modal analgesia. We evaluated analgesic efficacy of TAP block with Bupivacaine for 24hr after caesarean section done with pffannestiel incision under spinal anaesthesia, the pain being assessed with help of VAS. Total 130 parturients (ASA I OR II) posted for elective caesarean section under spinal anaesthesia were enrolled. They were allocated randomly in to two groups of 65 each. Group B patients received bilateral TAP block under USG at the end of surgery with 15ml of 0.25%Bupivacaine on each side while Group C patients did not receive TAP block. IV paracetamol 1gm was given in both groups as baseline analgesic at the end of surgery. Post-operative pain was assessed with VAS and rescue analgesia was given in form of Inj. Diclofenac Sodium Aq. at VAS score>4. Total rescue analgesia required in mg in post-operative 24 hours was noted.USG guided TAP block after caesarean section produced effective analgesia. Time for 1st rescue analgesia was delayed in group-B (mean+SD-12.25+4.54hr) than group-C (7.96+2.89hr) (P<0.001). Total analgesic requirement was reduced in group-B (107.35+50.32mg) than group-C (183+52.83mg) (P<0.001). USG-guided TAP block is easy to perform and effective as a component of multimodal analgesic regimen after caesarean section without any major complications.
Background: The aim is the current research is the comparison of Dexmedetomidine added to Levobupivacaine versus alone Levobupivacaine in supraclavicular brachial plexus blockade. Subjects and Methods : The current research was performed in the Department of Aneshtesia, Gov- ernment Medical College and SSG Hospital, Vadodara, from October 2014tooctober to 2015. Subjects were separated into 2 groups: Group LD: receives Inj. Levobupivacaine 0.5 %(35ml)+inj.Dexmedetomidine (0.5 l)+Inj.NS(0.5ml)=total 36 ml. Group L: receives Inj.Levobupivacaine0.5 %( 35ml) + inj. Normal saline(1ml) = 36 ml. Pulse rate, Blood pressure, Respiratory rate and Oxygen saturation (SpO2), Ramsay sedation score were monitored before giving the block, immediately after giving the block, each 5 minutes till fifteen minutes, every fifteen minutes thereafter for one hour and each thirty minutes afterward until the conclusion of surgery. Results: Total duration of sensory block was significantly extended in group LD as a contrast to group L. Total duration of motor block was significantly longer in group LD as a contrast to group L. Patients receiving Dexmedetomidine had long-lasting postoperative analgesia as compared to the control group. Thus, the total duration of analgesia was considerably extended in group LD patients as a contrast to group L patients and the dissimilarity was statistically highly significant. Conclusion: Dexmedetomidine can be utilized as a secure and useful aid to local anesthetics in supraclavicular brachial plexus block to give outstanding perioperative analgesia with negligible consequences.
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