Open AccessEffect Of Addition Of Dexmedetomidine To Ropivacaine In Ultrasound Guided Transverse Abdominis Plexus Block On Postoperative Pain In Open Appendicectomy
Author(s) -
Kamalakar Karampudi,
Kavya Waghray
Publication year - 2021
Publication title -
perspectives in medical research
Language(s) - English
Resource type - Journals
eISSN - 2348-229X
pISSN - 2348-1447
DOI - 10.47799/pimr.0901.13
Subject(s) - ropivacaine , dexmedetomidine , medicine , anesthesia , pacu , analgesic , saline , nerve block , surgery , sedation
Post operative pain is the most common complaint inpost anaesthesia care units (PACU). Lower abdominal surgeriesare associated with severe post-operative pain and inadequatepost-operative analgesia leads to many complications.Multimodality approach is used to treat postoperative pain.Transversus abdominus plane (TAP) block is a peripheral nerveblock of the trunk that provides analgesia between T10 to L1dermatomes with a single injection which was first describedby A.N. Rafi 1 in 2001 . TAP Block is indicated in any lowerabdominal surgeries. Local anaesthetic is deposited in thefascial sheath between the internal oblique and transverseabdominis muscle using either the blind or the ultrasoundguided technique. Adjuvants are frequently used in regionalanalgesia for rapid onset to improve the quality and prolongthe duration of block. Alpha 2 agonist dexmedetomidinespeeds the onset of block and prolongs duration of analgesia.Aim : To assess whether addition of dexmedetomidine toropivacaine may bring some improvements to the analgesicefficacy and quality of TAP blocks in patients undergoingappendicectomy surgeries .MATERIALS AND METHODS30 Patients belonging to ASA Class I or II scheduled forappendicectomy were selected for the study .The patients were randomized into two groups:Group R - receiving plain ropivacaine (2ml of normal salineand 20ml 0.2%ropivacaine)Group R+D - receiving ropivacaine with dexmedetomidine (0.5mcg /kg of dexmedetomidine dissolved in 2ml of normal salineand 20ml 0.2%ropivacaine). At the end of surgery, USG guidedtransversus abdominus plane block was performed.ResultsAddition of dexmedetomidine to ropivacine in TAPblock lower pain scores after 3hrs in postoperative period andthe same trend of analgesia continued for the first 24 hours.It confers better post operative analgesia with less analgesicrequirement and adverse effects.Conclusion: The addition of dexmedetomidine to ropivacaine in TAPblock confers better pain control and decreases the total doseof analgesics post-operatively without any major side-effect