Comparison of Efficacy of Bupivacaine with Dexmedetomidine Versus Bupivacaine Alone for Transversus Abdominis Plane Block for Post-operative Analgesia in Patients Undergoing Elective Caesarean Section

Parameswari, Aruna; Udayakumar, Prabha

doi:10.1007/s13224-017-0990-7

Cited by 17 publications

(13 citation statements)

References 26 publications

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“…In the current study, the results indicated that when compared with 0.3% ropivacaine alone, adding 0.5 µg/kg dexmedetomidine to 0.3% ropivacaine in TAP block prolonged pain-free duration, decreased post-operation VAS pain scores at 6 and 8 h post-surgery, reduced the number of patients who required rescue analgesic, prolonged the time to first request for analgesic and improved patient satisfaction without serious side effects. These results were consistent with a previous study by Ramya et al (31), which concluded that the addition of dexmedetomidine to bupivacaine in TAP block prolonged the time to first request of rescue analgesia and reduced the total dose of opioid requirement in the first 24 h post-CS. However, Ding et al (32) reported that adding dexmedetomidine did not significantly improve the quality or duration of TAP block.…”

Section: Discussionsupporting

confidence: 93%

Ultrasound‑guided transversus abdominis plane block using ropivacaine and dexmedetomidine in patients undergoing caesarian sections to relieve post‑operative analgesia: A randomized controlled clinical trial

et al. 2020

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Dexmedetomidine, which is a highly selective α2 adrenoreceptor agonist, enhances the analgesic efficacy and prolongs the analgesic duration when administered in combination with local anesthetics. The current study aimed to evaluate the effects of dexmedetomidine combined with ropivacaine in ultrasound-guided transversus abdominis plane (TAP) block on post-operative analgesia following cesarean section (CS). A total of 70 patients scheduled for CS were divided randomly into 2 groups: The ropivacaine (R) group, in which patients were administered bilateral 20 ml 0.3% ropivacaine and 2 ml 0.9% normal saline, and the dexmedetomidine (RD) group, in which patients were administered bilateral 20 ml 0.3% ropivacaine and 2 ml dexmedetomidine (0.5 µg/kg). The primary outcome was pain-free duration, and secondary outcomes included heart rate (HR) and mean blood pressure (MBP) measurements, visual analogue scale (VAS) pain scores, number of patients who required rescue analgesic, time to first request for analgesia and patient satisfaction. There was no significant difference in HR and MBP between the two groups at 1 h post-surgery (P>0.05). However, VAS pain scores decreased at 6 and 8 h post-surgery [2 (1-2) vs. 0 (0-0.25) and 2 (2-3) vs. 0 (0-1), respectively; P<0.05], pain-free duration was prolonged (5.91±1.08 vs. 9.62±1.46 h; P<0.05), the number of patients who required rescue analgesic was reduced (19 vs. 9; P<0.05), the time to first request for analgesia was prolonged (7.10±1.21 vs. 11.60±2.11 h; P<0.05) and patient satisfaction was improved [3.5 (3-4) vs. 4 (4-5); P<0.05] in the RD group compared with the R group. Furthermore, no bradycardia or hypotension was observed. In conclusion, the results of the present study demonstrated that adding 0.5 µg/kg dexmedetomidine to 0.3% ropivacaine used in TAP block in patients undergoing CS prolonged pain-free duration, decreased VAS pain scores, reduced the number of patients who required rescue analgesic, prolonged the time to first request for analgesia and improved the patient satisfaction without serious side effects.

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Section: Discussionsupporting

confidence: 93%

Ultrasound‑guided transversus abdominis plane block using ropivacaine and dexmedetomidine in patients undergoing caesarian sections to relieve post‑operative analgesia: A randomized controlled clinical trial

et al. 2020

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“…[ 33 ] Other studies also confirmed the previous finding in different abdominal operations. [ 34 35 36 ]…”

Section: Discussionmentioning

confidence: 99%

Levobupivacaine versus Levobupivacaine Plus Dexmedetomidine in Transversus Abdominis Plane Block in Patients Undergoing Abdominal Aortic Surgery

Abdallah

Abdallah²

2022

Anesthesia Essays &Amp; Researches

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Background: Severe postoperative pain is a major dilemma for patients undergoing abdominal aortic surgery. Transversus abdominis plane (TAP) block has been described a successful pain management technique after major abdominal surgery. Dexmedetomidine was proved to enhance the analgesic action of local anesthetics. Aim: This study was aimed to assess the impact of adding dexmedetomidine to levobupivacaine during TAP block in patients undergoing abdominal aortic operations. Patients and Methods: We included 114 patients in this prospective trial, and they were enrolled into two groups; the L group received levobupivacaine only, and the LD group received levobupivacaine plus dexmedetomidine. The block was performed before anesthetic induction. Postoperative pain score was our main outcome. Statistical Analysis: The collected data were tabulated and analyzed through the SPSS software program IBM's Statistical Package for the Social Sciences (SPSS) statistics for Windows (version 25, 2017) (IBM Corporation, Armonk, NY, USA). The categorical data were expressed as numbers and percentages and then compared using the Chi-square test. The continuous data were expressed as mean and standard deviation if normally distributed, or median and range if abnormally distributed. The former data were compared through the one-way ANOVA, while the latter were compared through the Kruskal–Wallis test. Any P < 0.05 was considered statistically significant. Results: Group LD showed significantly earlier sensory blocks compared to the other group. Postoperative pain scores were comparable between the two groups for the initial 4 h following the surgery. Adjuvant dexmedetomidine was associated with better pain scores for the subsequent 12 h compared to Group L. The duration till the first analgesic request showed a significant increase in the LD group (13.3 vs. 11.09 h in Group L). In addition, the same group showed a significant decline in their opioid consumption after the operation (48.95 μg vs. 72.63 μg in the other group). Postoperative nausea and vomiting were significantly increased in Group L. Conclusion: Adjuvant dexmedetomidine has a significant beneficial impact on postoperative analgesic profile. Its use as an adjuvant to peripheral and neuraxial nerve blocks should be recommended in pain management practice.

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“…This study revealed that the use of whether topically or intravenously dexmedetomidine provided a deeper postoperatively analgesia and lesser extra analgesic consumption. In a study by Ramya et al ( 17 ) in two groups of 35 patients, TAP block was performed after cesarean section by spinal anesthesia. In group B, 20 ml of 0.25% bupivacaine was used, and in group BD, 20 mL of bupivacaine 0.25% and 0.5 µ/kg dexmedetomidine was used, and patients were given paracetamol (1 g) immediately after block and every 8 hours in the ward.…”

Section: Discussionmentioning

confidence: 99%

“…The drowsiness of patients after waking up have also been attributed to general anesthesia. Ramya et al ( 17 ) used spinal anesthesia and did not indicate that patients fell asleep. In the present study, due to the fact that TAP block was performed by spinal anesthesia at the end of surgery and no sedative drug was prescribed during the operation, patients clearly experienced sedation and drowsiness, which were seen in group L for up to 2 hours and in groups M and H up to 4 hours, and in some cases, drowsiness, especially in group H, caused latency in patients’ discharge from the recovery ward.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Three Different Doses of Dexmedetomidine Added to Bupivacaine in Ultrasound-Guided Transversus Abdominis Plane Block; A Randomized Clinical Trial

et al. 2021

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Background: Adding dexmedetomidine to bupivacaine has been shown to prolong the analgesic effects of the transversus abdominis plane (TAP) block. However, the optimal dose of this adjuvant drug is unclear. Objectives: Identifying optimal doses of dexmedetomidine added to bupivacaine in the TAP block. Methods: In this randomized controlled trial, 86 patients candidate for elective open inguinal herniorrhaphy under spinal anesthesia were divided randomly into three groups; low (L), medium (M), and high (H) dose of dexmedetomidine, that finally 80 cases ended the study and were analyzed. At the end of the surgery, the patients underwent ultrasound-guided TAP block. In all patients of the three groups, the analgesic base of the block was 20 mL bupivacaine 0.125% that was supplemented with 0.5, 1, or 1.5 µ/kg of dexmedetomidine in groups L, M, and H, respectively. Results: The maximum duration of the block was 4 hours in group L and 8 hours in groups M and H. None of the patients needed to receive analgesic at 0, 2, and 24 hours after the block. The dose of analgesic required in the first 8 hours of the block in groups M and H was less than in group L (P < 0.02). Patients in groups H and M were more satisfied with the block (P < 0.01) and experienced less pain compared with group L (P < 0.01). Drowsiness and sedation were observed in patients up to 4 hours after the TAP block, which was dependent on the dexmedetomidine dose (P < 0.01). Conclusions: Based on our results, the optimal dose of supplemental dexmedetomidine could be 1 µ/kg in the TAP block.

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Comparison of Efficacy of Bupivacaine with Dexmedetomidine Versus Bupivacaine Alone for Transversus Abdominis Plane Block for Post-operative Analgesia in Patients Undergoing Elective Caesarean Section

Abstract: The addition of dexmedetomidine to bupivacaine in TAP block prolonged the duration of time at which first dose of rescue analgesia was sought and also reduced the total dose of opioid requirement in the first 24-h post-Caesarean section.

Cited by 17 publications

References 26 publications

Ultrasound‑guided transversus abdominis plane block using ropivacaine and dexmedetomidine in patients undergoing caesarian sections to relieve post‑operative analgesia: A randomized controlled clinical trial

Ultrasound‑guided transversus abdominis plane block using ropivacaine and dexmedetomidine in patients undergoing caesarian sections to relieve post‑operative analgesia: A randomized controlled clinical trial

Levobupivacaine versus Levobupivacaine Plus Dexmedetomidine in Transversus Abdominis Plane Block in Patients Undergoing Abdominal Aortic Surgery

Comparison of Three Different Doses of Dexmedetomidine Added to Bupivacaine in Ultrasound-Guided Transversus Abdominis Plane Block; A Randomized Clinical Trial

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