INTRODUCTION
Post operative pain is the most common complaint in
post anaesthesia care units (PACU). Lower abdominal surgeries
are associated with severe post-operative pain and inadequate
post-operative analgesia leads to many complications.
Multimodality approach is used to treat postoperative pain.
Transversus abdominus plane (TAP) block is a peripheral nerve
block of the trunk that provides analgesia between T10 to L1
dermatomes with a single injection which was first described
by A.N. Rafi 1
in 2001 . TAP Block is indicated in any lower
abdominal surgeries. Local anaesthetic is deposited in the
fascial sheath between the internal oblique and transverse
abdominis muscle using either the blind or the ultrasound
guided technique. Adjuvants are frequently used in regional
analgesia for rapid onset to improve the quality and prolong
the duration of block. Alpha 2 agonist dexmedetomidine
speeds the onset of block and prolongs duration of analgesia.
Aim : To assess whether addition of dexmedetomidine to
ropivacaine may bring some improvements to the analgesic
efficacy and quality of TAP blocks in patients undergoing
appendicectomy surgeries .
MATERIALS AND METHODS
30 Patients belonging to ASA Class I or II scheduled for
appendicectomy were selected for the study .
The patients were randomized into two groups:
Group R - receiving plain ropivacaine (2ml of normal saline
and 20ml 0.2%ropivacaine)
Group R+D - receiving ropivacaine with dexmedetomidine (0.5
mcg /kg of dexmedetomidine dissolved in 2ml of normal saline
and 20ml 0.2%ropivacaine). At the end of surgery, USG guided
transversus abdominus plane block was performed.
Results
Addition of dexmedetomidine to ropivacine in TAP
block lower pain scores after 3hrs in postoperative period and
the same trend of analgesia continued for the first 24 hours.
It confers better post operative analgesia with less analgesic
requirement and adverse effects.
Conclusion:
The addition of dexmedetomidine to ropivacaine in TAP
block confers better pain control and decreases the total dose
of analgesics post-operatively without any major side-effect