Effect of dexmedetomidine as an adjuvant to ropivacaine in ultrasound-guided transversus abdominis plane block for post-operative pain relief in cesarean section

Bansal, Prannal; Sood, Dinesh

doi:10.4103/joacc.joacc_53_17

Cited by 9 publications

(10 citation statements)

References 2 publications

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“…Similar results were observed by Almarkbi and Kaki, who studied the effect of addition of dexmedetomidine to bupivacaine to perform TAP block. 12,13 They concluded that the addition of dexmedetomidine to bupivacaine in TAP block achieves better local anesthesia and provides better pain control post-operatively with lower heart rate from 60 min from block to 4 hours postoperatively. Similarly, analgesia period was significantly higher in the patients who received bupivacaine and dexamethasone as an adjunct in comparison to the patients who received bupivacaine alone.…”

Section: Resultsmentioning

confidence: 99%

“…A USG guided TAP block was given using linear probe (6)(7)(8)(9)(10)(11)(12)(13) in all groups with respective drug solutions. 23 G spinal needle was advanced by ultrasound guided in plane technique at the anterior axillary line between the 12 th rib and iliac crest with umbilicus at the center and exact location of the needle tip in a plane between internal oblique muscle, transverse abdominis muscle was identified with 1ml of normal saline.…”

Section: Methodsmentioning

confidence: 99%

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A prospective randomized study to compare dexmedetomidine and dexamethasone as an adjunct to bupivacaine in transversus abdominis plane block for post-operative analgesia in caesarean delivery

Thakur¹,

Gupta²,

Gupta³

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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Background: Caesarean section is most frequently performed surgery worldwide. Patients experience moderate to severe pain in the first 48 hours post-operatively. Aim of this study was to evaluate the efficacy of dexmedetomidine and dexamethasone as an adjunct to bupivacaine in ultrasound guided TAP block for postoperative analgesia in patients of caesarean section.Methods: A total 120 ASA I and II patients undergoing elective and emergency caesarean section under subarachnoid block were randomly divided into three groups B, BDM, BDX to receive bupivacaine alone or dexmedetomidine or dexamethasone as an adjunct to bupivacaine in ultrasound guided TAP block. Postoperatively, the patients were evaluated for pain level at rest and on movement with a 10 cm visual analog scale (VAS) pain score (0 = no pain and 10 = worst pain), time to demand of first analgesic request, number of analgesic requirements, nausea or vomiting, sedation and patient satisfaction at 0 hours and at 2, 4, 6, 12, 18, and 24 hours.Results: VAS score was significantly higher in group B in comparison to BDM and BDX, and higher in BDX in comparison to group BDM. Mean duration of analgesia was significantly higher in group BDM in comparison to group B and BDX. Total number of rescue analgesic demands were significantly lower in group BDM in comparison to group B and BDX. Sedation score and satisfaction score was higher in group BDM as compared to group B and BDX.Conclusions: Addition of dexmedetomidine and dexamethasone as an adjunct to bupivacaine reduces postoperative pain, prolongs analgesia, decreases demand for additional analgesics and provides better maternal satisfaction as compared to plain bupivacaine group in TAP block in patients undergoing caesarean section under subarachnoid block. Among dexmedetomidine and dexamethasone, dexmedetomidine had prolonged analgesia as compared to dexamethasone group.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

A prospective randomized study to compare dexmedetomidine and dexamethasone as an adjunct to bupivacaine in transversus abdominis plane block for post-operative analgesia in caesarean delivery

Thakur¹,

Gupta²,

Gupta³

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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“…Pain management after caesarean section is usually multimodal, incorporating regional nerve blocks as part of opioid sparing analgesic technique. [ 1 ]…”

Section: Introductionmentioning

confidence: 99%

“…Various adjuvants to local anaesthetics like opioids, ketamine, dexamethasone and alpha-2 agonists like dexmedetomidine have been utilised successfully in peripheral nerve blocks and field blocks to enhance the duration of post-operative analgesia. [ 1 3 4 5 ]…”

Section: Introductionmentioning

confidence: 99%

Analgesic efficacy of dexamethasone versus dexmedetomidine as an adjuvant to ropivacaine in ultrasound-guided transversus abdominis plane block for post-operative pain relief in caesarean section: A prospective randomised controlled study

Singla¹,

Garg²,

Jain³

et al. 2021

Indian Journal of Anaesthesia

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Background and Aims: Transversus abdominis plane (TAP) block is commonly used to treat post-operative pain after lower abdominal surgeries. The aim of this randomised controlled study was to assess the efficacy of addition of dexmedetomidine or dexamethasone to ropivacaine in TAP block and compare the two for post-operative pain relief in caesarean section. Methods: A hundred parturients (18–45 years) undergoing caesarean section under spinal anaesthesia received ultrasound-guided (USG) bilateral TAP block with 50ml of 3mg/kg ropivacaine along with 0.1mg/kg dexamethasone (Group A) or 1μg/kg dexmedetomidine (Group B) in this prospective, randomised, double-blind study. Time to initial self-reporting of post-operative pain, time to first rescue analgesic demand, visual analogue scale (VAS) for pain haemodynamic parameters and adverse effects if any were noted, anda P value < 0.005 was considered as statistically significant. Results: Time to initial self-reporting of post-operative pain (411.35 vs. 338.20 min, P < 0.005) and time to first rescue analgesic (474.30 vs. 407.30 min, P < 0.005) were significantly longer in group B as compared to group A. VAS score at the time of initial self-reporting of pain was significantly lower in group B. No significant haemodynamic changes or side-effects were noted. Conclusion: Addition of dexmedetomidine to ropivacaine as compared with dexamethasone in bilateral TAP block following caesarean section prolongs the time to initial post-operative pain and time to first rescue analgesic consumption.

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“…Dexamethasone, Clonidine, Fentanyl, Morphine are commonly used adjuvants, but they were less efficacious and had unwanted side effects. 4 dexmedetomidine is a highly selective α2 adrenergic agonist with analgesic and sedative properties. It is safe and has less bradycardia and hypotension than Clonidine.…”

mentioning

confidence: 99%

Addition of dexmedetomidine to bupivacaine in Transversus Abdominis Plane Block in Inguinal Hernia Repair: A Perspective Double Blind Study

Royzada¹,

Kujur²,

Royzada³

et al. 2019

jebmh

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BACKGROUND Dexmedetomidine an α 2 adrenergic agonist is well known for potentiating the effect of local anaesthetics in neuraxial blockade and peripheral nerve blocks. It prolongs the duration of analgesia produced by local anaesthetic, as well as reduces the dose of local anaesthetic required to produce the block. This helps in early mobilization and recovery of the patient. We conducted this study to access the effect of adding dexmedetomidine to bupivacaine in transversus abdominis plane (TAP) block in inguinal hernia repair. METHODS 60 patients posted for inguinal hernia repair were divided into two groups of 30 each in randomized double-blind manner. Group B patients (n=30) received 20 ml of 0.25% of bupivacaine and 2ml normal saline for TAP block whereas Group D received 20 ml 0.25% bupivacaine and 0.5 µgm/Kg of dexmedetomidine (2 ml). NPRS scores for postoperative pain, time to request for first analgesic dose, total duration of analgesia, Inj. Diclofenac consumption, haemodynamic parameters and side effects were recorded. RESULTS Numerical pain rating scale scores were significantly lower in group D. Total analgesic requirement was significantly less in group D. Time to request for first analgesic dose was longer in group D as compared to group B. Patients were haemodynamically stable in both the groups. CONCLUSIONS The addition of dexmedetomidine to bupivacaine in TAP block provides prolonged and effective postoperative analgesia with haemodynamic stability.

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Effect of dexmedetomidine as an adjuvant to ropivacaine in ultrasound-guided transversus abdominis plane block for post-operative pain relief in cesarean section

Cited by 9 publications

References 2 publications

A prospective randomized study to compare dexmedetomidine and dexamethasone as an adjunct to bupivacaine in transversus abdominis plane block for post-operative analgesia in caesarean delivery

A prospective randomized study to compare dexmedetomidine and dexamethasone as an adjunct to bupivacaine in transversus abdominis plane block for post-operative analgesia in caesarean delivery

Analgesic efficacy of dexamethasone versus dexmedetomidine as an adjuvant to ropivacaine in ultrasound-guided transversus abdominis plane block for post-operative pain relief in caesarean section: A prospective randomised controlled study

Addition of dexmedetomidine to bupivacaine in Transversus Abdominis Plane Block in Inguinal Hernia Repair: A Perspective Double Blind Study

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