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

Thakur, Jitender; Gupta, Bharti; Gupta, Amit; Verma, Ravinder; Verma, Anita; Shah, Pranay

doi:10.18203/2320-1770.ijrcog20195342

Cited by 6 publications

(4 citation statements)

References 10 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Also, postoperative hemodynamics results in Thakur et al (23) study were similar to our results. They observed that HR and DBP showed significant difference at 2h and at 0,2,4,12,18,24 h postoperative respectively.…”

Section: Resultssupporting

confidence: 91%

Dexamethasone versus Dexmedetomidine as Adjuvant to Bupivacaine in Ultrasound Guided Erector Spinae Plane Block for Analgesia in Total Abdominal Hysterectomy

Ali¹,

Salama²,

Abaza³

et al. 2022

The Egyptian Journal of Hospital Medicine

View full text Add to dashboard Cite

Background: Local anesthetic adjuvants prolong analgesia duration with single shot interfascial plane blocks. They potentiate the analgesic effect of the local anesthetics. These adjuvants include several groups and different mechanisms of action such as dexamethasone and dexmedetomidine. Objectives: This study was aimed at achievement of better analgesia for total abdominal hysterectomy patients via prolongation of sensory block duration and reducing opioid consumption. Patients and Methods: This study was carried out at Zagazig University Hospitals where 84 female patients scheduled for total abdominal hysterectomy aged from 40 to 60 years, ASA physical status grade I, II and body mass index (BMI) 18.5-30 kg/m 2 . Patients were classified into three groups (28 each), group C (received bilateral ESPB with 20 ml bupivacaine 0.25% plus 1ml saline), group O (received bilateral ESPB with 20 ml bupivacaine 0.25% plus 1ml dexamethasone (4mg)), group D (received bilateral ESPB with 20 ml bupivacaine 0.25% plus 1 ml dexmedetomidine (0.5ug/kg) in saline). They underwent history taking, general examination, laboratory investigations, preoperative erector spinae plane block (ESPB) and GA. Results: There was statistically significant difference between three groups regarding visual analog scale (VAS) and nalbuphine consumption where D group had better pain control than other groups. Conclusions: It could be concluded that dexmedetomidine as an adjuvant to 0.25% bupivacaine in ultrasound guided erector spinae plane block is more efficacious than dexamethasone in hastening the onset, prolonging sensory blockade, delaying the time for request of rescue analgesia, and decreasing total nalbuphine consumption.

show abstract

Section: Resultssupporting

confidence: 91%

Dexamethasone versus Dexmedetomidine as Adjuvant to Bupivacaine in Ultrasound Guided Erector Spinae Plane Block for Analgesia in Total Abdominal Hysterectomy

Ali¹,

Salama²,

Abaza³

et al. 2022

The Egyptian Journal of Hospital Medicine

View full text Add to dashboard Cite

show abstract

“…12 Our results are in agreement to that of Swami et al They found in their study on 60 patients undergoing supraclavicular brachial plexus block that addition of dexmedetomidine 1 µg/kg to bupivacaine 0.25%clonidine 1µg/kg mixture significantly prolonged the duration of analgesia more than bupivacaine-clonidine mixture only. 13 Similar findings have been reported in a study comparing dexamethasone (0.1 mg/kg) and dexmedetomidine (1 µg/kg) as adjuvants to bupivacaine (0.25%) in USGguided TAP block in patients undergoing cesarean section under spinal anasthesia. The investigators concluded that addition of dexmedetomidine reduces postoperative pain, prolongs duration of analgesia and decreases demand for additional analgesic requirement as compared with dexamethasone added to bupivacaine.…”

Section: Discussionsupporting

confidence: 84%

A comparative study between the use of dexmedetomidine vs. dexamethasone as adjuvants to bupivacaine in ultrasound-guided transversus abdominis plane block for postoperative pain relief in patients undergoing lower abdominal surgeries

Abdelhady¹,

Ghallab²,

Zaki³

et al. 2022

Anaesth. pain intensive care

View full text Add to dashboard Cite

Background & objective: Transversus abdominis plane (TAP) block using local anesthetics is associated with relatively shorter duration of action, and thus additional analgesic drugs are required in the postoperative period. We compared the efficacy and duration of postoperative analgesia achieved with using dexmedetomidine or dexamethasone as adjuvants to bupivacaine in TAP block for lower abdominal surgeries. Methodology: We enrolled 45 adult patients aged from 20-60 y, and randomly divided them into three equal groups. Group A received ultrasound guided TAP block with 0.25% bupivacaine 20 ml plus 4 mg dexamethasone on each side. Group B received 0.25% bupivacaine 20 ml plus dexmedetomidine 0.5 µg/kg on each side, and Group C (control group) patients received only 0.25% bupivacaine 20 ml on each side. Postoperative pain was assessed with VAS on arrival in post-anesthesia care unit (PACU), at 2 h, 6 h, 12 h, 18 h, and at 24 h postoperatively. Duration of analgesia was the time from drug injection to the time of first rescue of analgesia was recorded. Results: Mean duration to first dose of rescue analgesia among patients of dexmedetomidine group (Group B) was significantly prolonged as compared to dexamethasone group and bupivacaine only group. Regarding postoperative pain scores there were no statistically significant difference between the three groups; except at 6 h between the A and B groups and the control group. Both dexamethasone group and dexmedetomidine group showed better pain control than bupivacaine only at 6 h interval. Conclusion: Dexmedetomidine added to bupivacaine in ultrasound-guided transversus abdominis plane block for postoperative pain relief in patients undergoing lower abdominal surgeries prolongs the time to initial postoperative pain presented by time to first rescue analgesic demand than dexamethasone added to bupivacaine; the shortest time to first rescue analgesic was observed in bupivacaine alone group. Abbreviations: TAP: Transversus abdominis plane block; LA: Local anesthetic; PACU: Post anesthesia care unit; VAS: Visual Analogue Scale; ASA: American Society of Anesthesiologists; SD: Standard deviation; IQR: Inter quartile range. Citation: Sobhy YS, Gadalla RR, Nofal WH, Saleh MAE, Abdou KM. A comparative study between the use of dexmedetomidine .vs dexamethasone as adjuvants to bupivacaine in ultrasound-guided transversus abdominis plane block for postoperative pain relief in patients undergoing lower abdominal surgeries. Anaesth. pain intensive care 2022;26(5):681–688; DOI: 10.35975/apic.v26i5.2031

show abstract

“…The investigators concluded that addition of dexmedetomidine reduces post-operative pain, prolongs duration of analgesia and decreases demand for additional analgesic requirement as compared with dexamethasone with bupivacaine in TAP block for post-operative pain relief in caesarean section. [ 10 ]…”

Section: Discussionmentioning

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 J Anaesth

View full text Add to dashboard Cite

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.

show abstract

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

Cited by 6 publications

References 10 publications

Dexamethasone versus Dexmedetomidine as Adjuvant to Bupivacaine in Ultrasound Guided Erector Spinae Plane Block for Analgesia in Total Abdominal Hysterectomy

Dexamethasone versus Dexmedetomidine as Adjuvant to Bupivacaine in Ultrasound Guided Erector Spinae Plane Block for Analgesia in Total Abdominal Hysterectomy

A comparative study between the use of dexmedetomidine vs. dexamethasone as adjuvants to bupivacaine in ultrasound-guided transversus abdominis plane block for postoperative pain relief in patients undergoing lower abdominal surgeries

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

Contact Info

Product

Resources

About