A Comparative Study of Ropivacaine and Ropivacaine With Dexmedetomidine as Postoperative Analgesia for Lower Abdominal Surgeries Under Ultrasound-Guided Transversus Abdominis Plane Block

S, Ramesh Kumar; Vasanthageethan, R.; Selvaraju, G

doi:10.14260/jemds/2017/263

Cited by 3 publications

(1 citation statement)

References 12 publications

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“…Most studies[ 10 15 21 ] have used either 1 mcg/kg or 0.5 mcg/kg of dexmedetomidine as an adjuvant to the LA in a TAP block. However, we have selected different doses of dexmedetomidine to evaluate whether the addition of a lesser dose of dexmedetomidine (0.25 mcg/kg) is as effective as 0.5 mcg/kg in terms of the quality of analgesia.…”

Section: Discussionmentioning

confidence: 99%

A comparative evaluation of different doses of dexmedetomidine as an adjuvant to bupivacaine in transversus abdominis plane block for postoperative analgesia in unilateral inguinal hernioplasty

Madangopal

Dang

Aggarwal

et al. 2020

J Anaesthesiol Clin Pharmacol

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Background and Aims: The present study is designed to evaluate addition of two different doses of dexmedetomidine (0.25 mcg/kg and 0.5 mcg/kg) as an adjuvant to bupivacaine in transversus abdominis plane block for post-operative analgesia in patients undergoing unilateral inguinal hernioplasty. Material and Methods: A total of 90 patients scheduled to undergo elective unilateral open inguinal hernioplasty were divided into three groups in a randomized triple blind way. In group B ( n = 30), patients received TAP block using 22 ml of solution, consisting of 20 ml of 0.25% bupivacaine and 2 ml of normal saline; in group BD1 ( n = 30), patients received TAP block using 22 ml of solution, consisting of 20 ml of 0.25% bupivacaine and dexmedetomidine 0.25 mcg/kg dissolved in 2 ml of normal saline; while in group BD2 ( n = 30), patients received TAP block using 22 ml of solution, consisting of 20 ml of 0.25% bupivacaine and dexmedetomidine 0.5 mcg/kg dissolved in 2 ml of normal saline. Results: Time to first analgesia was significantly prolonged in group BD2 (874.48 ± 118.28 minutes) as compared to BD1 (536.5 ± 60.35 minutes) and B (341.5 ± 46.22 minutes) ( P < 0.0001). Total consumption of diclofenac was also reduced in BD2 (80.17 ± 19.34 mg) as compared with B (150 ± 0 mg) and BD1 (147.5 ± 13.69 mg) ( P < 0.001). Patients in dexmedetomidine group were more sedated at 1-hour ( P < 0.05). None of our patients required any intervention for hemodynamic changes which were significantly more in dexmedetomidine group. Conclusion: Dexmedetomidine in a dose of 0.5 mcg/kg is better than dose of 0.25 mcg/kg as an adjuvant to 0.25% bupivacaine in transversus abdominis plane block for post-operative pain relief in unilateral inguinal hernioplasty. However, it causes mores sedation and hemodynamic changes.

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Section: Discussionmentioning

confidence: 99%

A comparative evaluation of different doses of dexmedetomidine as an adjuvant to bupivacaine in transversus abdominis plane block for postoperative analgesia in unilateral inguinal hernioplasty

Madangopal

Dang

Aggarwal

et al. 2020

J Anaesthesiol Clin Pharmacol

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Effect of Adding Dexmedetomidine to Local Anesthetic Agents for Transversus Abdominis Plane Block

Bansal¹,

Garg

2019

The Clinical Journal of Pain

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Background: Dexmedetomidine (Dex) has been used as an adjuvant in transversus abdominis plane (TAP) blocks. This meta-analysis was aimed at evaluating the effect of Dex in TAP blocks. Objectives: Outcome measures were total opiate consumption in 24 hours after surgery, time to systemic rescue analgesia, pain scores after surgery, and adverse events (AEs). Materials and Methods: Randomized controlled trials comparing Dex with local anesthetics to local anesthetics alone for analgesia after abdominal surgeries were included. Standardized mean difference (SMD) and mean difference (MD) were used for continuous variables and odds ratio for frequency data. Results: Analysis of data from 9 randomized controlled trials (598 patients) showed that the addition of Dex to LAs decreased opiate use in 24 hours after surgery (SMD, −3.07; 95% confidence interval [CI], −4.78 to −1.35), increased time to rescue analgesia (171.8 min; 95% CI, 112.34-231.26), and decreased pain scores (scale of 0 to 10) at 4 hours (MD, −0.36; 95% CI, −0.65 to −0.07) and 8 hours (MD, −0.17; 95% CI, −0.29 to −0.04) after surgery. Frequency of adverse events was similar between the 2 groups (odds ratio, 1; 95% CI, 0.61-1.63). The estimates for pain scores were prone to sensitivity analysis. The estimates for postoperative opiate use, time to rescue analgesia, and pain scores at 8 hours had significant heterogeneity. Conclusions: The addition of Dex to LAs in the TAP block for analgesia after abdominal surgeries decreased 24-hour opiate use and increased the overall time to rescue analgesia including certain subgroups without increasing adverse events. Its effect on postoperative pain scores was not as definitive.

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To compare postoperative analgesic effect of ropivacaine with or without dexamethasone in ultra sound guided transversus abdominis plane block for patients undergoing lower abdominal surgeries - A prospective & randomized study

Banerjee¹,

Pareek²,

Goyal³

2021

IJCA

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Background and Aims: Ultrasound guided transversus abdominis plane block is an efficacious abdominal field block. The aim was to determine the effect of adding dexamethasone to 0.375% ropivacaine on the analgesic duration of TAP block in patients undergoing lower abdominal surgeries. Materials and Methods: A double blinded randomised control study conducted on 60 patients, 30 in each group. Group A: 0.375% ropivacaine (19 ml) with dexamethasone 4mg (1 ml) total 20ml each side. Group B: 0.375% ropivacaine (19 ml) with normal saline (1 ml) total 20ml each side in TAP block after lower abdominal surgery. Primary objective, to compare the duration of postoperative analgesia provided by the block and secondary objectives to compare the total amount of rescue analgesia required in first 24 h postoperatively and any side effect of ropivacaine in TAP block. Numeric rating scale scores used to assess pain between the two groups. Ethical committee approval was obtained. Results: Duration of analgesia was significantly longer in group A with time of first analgesia need (12.44 ± 1.60 h) compared to group B (10.69 ± 1.79 h), P <0.001.Group A had decreased total rescue analgesic ampoule requirement postoperatively compared to group B (1.27 ± 0.64 vs. 1.63 ± 0.56 ampoule, P = 0.024) (P < 0.005). NRS scores for pain was significantly higher in group B than group A at 1hr, 2hr, and 4 hr postoperatively. Conclusion: Addition of dexamethasone to ropivacaine in TAP block significantly prolongs the duration of postoperative analgesia.

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A Comparative Study of Ropivacaine and Ropivacaine With Dexmedetomidine as Postoperative Analgesia for Lower Abdominal Surgeries Under Ultrasound-Guided Transversus Abdominis Plane Block

Cited by 3 publications

References 12 publications

A comparative evaluation of different doses of dexmedetomidine as an adjuvant to bupivacaine in transversus abdominis plane block for postoperative analgesia in unilateral inguinal hernioplasty

A comparative evaluation of different doses of dexmedetomidine as an adjuvant to bupivacaine in transversus abdominis plane block for postoperative analgesia in unilateral inguinal hernioplasty

Effect of Adding Dexmedetomidine to Local Anesthetic Agents for Transversus Abdominis Plane Block

To compare postoperative analgesic effect of ropivacaine with or without dexamethasone in ultra sound guided transversus abdominis plane block for patients undergoing lower abdominal surgeries - A prospective & randomized study

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