Comparative Study between Levobupivacine versus Levobupivacaine Plus Dexmedetomidine for Transversus Abdominis Plane Block “TAP” in Post-Operative Pain Management after Abdominoplasty

Abdelaal, Wail Ahmed; Metry, Ayman Anis; Refaat, Mona; Ragaei, Milad Z; Nakhla, George

doi:10.18650/2374-4448.22004

Cited by 8 publications

(8 citation statements)

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“…Sinha S, Palta S, et al 19 showed in their study that ultrasound-guided TAP block in patients of laparoscopic cholecystectomies with ropivacaine 0.375% provided superior analgesia in the early post-operative period in comparison to bupivacaine 0.25%. Our study was consistent with the study done by Abdelaal W, Metry AA, et al 20 who reported that addition of dexmedetomidine to levobupivacaine in TAP block in patients of abdominoplasty improves analgesia (205±10.2 min vs 181±12.6 min) and decreases opioid consumption.…”

Section: Discussionsupporting

confidence: 93%

Addition of Dexmedetomidine to Ropivacaine in Transversus Abdominis Plane Block Potentiates Post-Operative Pain Relief among Laparoscopic Cholecystectomy Patients- A Randomized Controlled Trail

Goswami¹,

Dey²,

Dutta³

et al. 2019

jemds

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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.

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Section: Discussionsupporting

confidence: 93%

Addition of Dexmedetomidine to Ropivacaine in Transversus Abdominis Plane Block Potentiates Post-Operative Pain Relief among Laparoscopic Cholecystectomy Patients- A Randomized Controlled Trail

Goswami¹,

Dey²,

Dutta³

et al. 2019

jemds

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“…agreed with the co-analgesic effect of dexmedetomidine added to levobupivacaine in TAP block for patients with abdominoplasty. [ 21 ] In general, we can say that adding dexmedetomidine to local anesthetics in perineural injection prolong action as described by Channabasapp et al . [ 22 ] and Agarwal et al .…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine in a surgically inserted catheter for transversus abdominis plane block in donor hepatectomy: A prospective randomized controlled study

et al. 2018

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Background:Transversus abdominis plane (TAP) block is a promising technique for analgesia after abdominal surgery. This prospective, randomized controlled trial assessed the effect of adding dexmedetomidine to bupivacaine in TAP block for donor hepatectomy. We hypothesized that this would improve postoperative morphine consumption and reduce analgesia related complication and inflammation.Methods:A total of 50 donor hepatectomy were enrolled in this study. Patients divided into two equal groups according to drugs used for TAP block. Group (B) received 20 ml of bupivacaine hydrochloride 0.25%, Group (BD) received 20 ml of bupivacaine hydrochloride 0.25% and 0.3 μg/kg dexmedetomidine, on both sides at the end of surgery and every 8 h for 48 h at right side only through inserted catheter. Primary outcome objective was morphine consumption at first 72 h. Secondary outcome objectives were morphine requirement, numbers of intake, time to first intake, pain score numerical analog scale (NAS), postoperative analgesia related complications, recovery of intestinal motility, and inflammatory markers.Results:Data were analyzed, rescue morphine analgesia was significantly lower in (BD) group compared with (B) groups as considering total morphine consumption (B 4 ± 1.9, BD 1.5 ± 0.5, P = 0.03), numbers of morphine intake (P = 0.04), morphine requirement (P = 0.03), and first time of analgesia intake (P = 0.04). NAS was significantly lower in group (BD) compared with group (B) group in the first 12 h (NAS 0 - P = 0.001, NAS 1 - P = 0.03). Adding dexmedetomidine improved gut motility, first oral intake without detectable anti-inflammatory effect.Conclusion:Adding dexmedetomidine to bupivacine in a surgically inserted catheter for TAP block in donor hepatectomy reduced morphine consumption without detectable anti-inflammatory effect.

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“…In a different trial, Abdelaal et al [15] examined the efficacy of combining levobupivacaine and DEX in preemptive TAP blocks for postoperative pain control following abdominoplasty. The research study comprised 69 patients in total.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of Levobupivacaine Versus Levobupivacaine With Dexmedetomidine as an Adjuvant in Transversus Abdominis Block for Postoperative Pain Relief in Abdominal Hysterectomy Patients: A Randomized, Double-Blind Study

Romi,

Hoda,

Kumar

et al. 2024

Cureus

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BackgroundAdjuvants have been discovered to prolong the analgesic impact of local anesthetics (LA), while the transversus abdominis plane (TAP) block offers sufficient postoperative pain relief after various abdominal procedures. Nevertheless, the impact of the given LA will determine the duration of the TAP block. Thus, in this investigation, we aimed to estimate the analgesic impact of combining dexmedetomidine (DEX) with levobupivacaine in the TAP block for patients having an infraumbilical incision for an abdominal hysterectomy while under spinal anesthetic. AimThis study aimed to determine the analgesic effect of DEX (0.5 mcg/kg) to 20 ml of 0.25% levobupivacaine on each side in the TAP block in patients undergoing total abdominal hysterectomy (TAH). Materials and methodsTwo groups of 30 patients each, with ASA grades 1 and 2, were randomly selected from patients. Group N, comprising 30 patients, had a bilateral TAP block using 2 mL of normal saline and 20 mL of 0.25% levobupivacaine. Group D (n = 30 patients) was given DEX at a dose of 0.5 mcg/kg (2 mL) in addition to 20 mL of 0.25% levobupivacaine given bilaterally. The TAP block was administered just after skin closure. Time of the initial analgesic dose administration; total fentanyl doses utilized as rescue analgesia; pain scores (numerical rating scale (NRS)) at 2, 4, 6, 8, 12, and 24 hours; and pre-and postoperative cortisol levels were also noted. For each group, 1 gram IV paracetamol was administered every eight hours. Drugs used for rescue analgesia (RA) were diclofenac 75 mg IV stat and fentanyl 1 mcg/kg. Results and discussionIn addition to Group N having lower NRS scores at rest, Group D had a considerably longer time for initial rescue analgesia than Group N. There was also a significant decrease in the total fentanyl consumption and postoperative serum cortisol levels in Group D in contrast to Group N. ConclusionPotential adjuvant DEX prolongs postoperative analgesia in patients experiencing abdominal hysterectomy when used alongside LA in TAP.

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Comparative Study between Levobupivacine versus Levobupivacaine Plus Dexmedetomidine for Transversus Abdominis Plane Block “TAP” in Post-Operative Pain Management after Abdominoplasty

Cited by 8 publications

References 0 publications

Addition of Dexmedetomidine to Ropivacaine in Transversus Abdominis Plane Block Potentiates Post-Operative Pain Relief among Laparoscopic Cholecystectomy Patients- A Randomized Controlled Trail

Addition of Dexmedetomidine to Ropivacaine in Transversus Abdominis Plane Block Potentiates Post-Operative Pain Relief among Laparoscopic Cholecystectomy Patients- A Randomized Controlled Trail

Dexmedetomidine in a surgically inserted catheter for transversus abdominis plane block in donor hepatectomy: A prospective randomized controlled study

Comparative Study of Levobupivacaine Versus Levobupivacaine With Dexmedetomidine as an Adjuvant in Transversus Abdominis Block for Postoperative Pain Relief in Abdominal Hysterectomy Patients: A Randomized, Double-Blind Study

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