EFFECT OF DEXMEDETOMIDINE COMBINED WITH ROPIVACAINE IN ULTRASOUND-GUIDED TRANSVERSUS ABDOMINIS PLANE BLOCK IN PATIENTS UNDERGOING CAESARIAN SECTIONS

Abstract

Background: The Transversus Abdominis Plane (TAP) block is the most common peripheral nerve block that provides acceptable postoperative analgesia for a variety of abdominal surgeries. A long-acting local anesthetic called ropivacaine is used to relieve pain following surgery. The duration of analgesia may be extended by the adjuvant administration of dexmedetomidine.
Aim: The current study aimed to evaluate the effects of dexmedetomidine combined with Ropivacaine in ultrasound-guided Transversus Abdominis plane block on post-operative analgesia following cesarean section.
Materials and Method: A total of 70 patients scheduled for CS were divided randomly into two groups: $ (Ropivacaine) group, which received 3 mg/kg of Ropivacaine diluted to 40 mL in normal saline with 20 mL on each side, and B (dexmedetomidine) group, which received 3 mg/kg of  Ropivacaine plus 0.5 µg/kg of dexmedetomidine diluted to 40 mL in normal saline with 20 mL on each side. The primary outcome was pain-free duration, with secondary outcomes included heart rate (HR) and mean blood pressure (MBP) readings, visual analogue scale (VAS) pain scores, number of patients requiring rescue analgesia, time to first seek analgesia, and patient satisfaction.
Results were analysed using SPSS 20.0 version and the association was tested using the Student's ttest, Fisher's exact test or Pearson's χ2 test.
Results: As compared to group A, group B experienced a significantly longer period of sensory block and analgesia (p<0.05). In comparison to Group A, group B showed longer pain-free duration (6.25±1.47 vs. 9.74±1.31 hours; p<0.05), a longer mean time to initial reporting of  postoperative pain (5.12±1.23 vs. 7.07±1.48; p<0.05), a lower number of patients requiring rescue analgesic (27(77.14%) vs. 8(22.86%); p<0.05), a longer time to first request for analgesia (5.76±1.87 vs. 7.63±2.07 hours; p<0.05), and better patient satisfaction (3.5 vs. 4.5; p<0.05). Postoperative VAS pain scores in group B were considerably lower at 6, 8, and 10 hours than in group A. Bradycardia was noted in 1 (2.86%) and 3 (8.57%) of the patients in Groups A and B, respectively.
Conclusion: Extending the duration and improving the quality of analgesia without causing any notable side effects is possible with the adjuvant addition of dexmedetomidine to Ropivacaine for TAP block.