A Randomized Control Study to Evaluate (0.25%) Bupivacaine and (0.5%) Ropivacaine for Post Operative Analgesia using Transversus Abdominis Plane Block (TAPB) in Lower Segment Caesarean Section

Abstract

Introduction: Patient undergoing caesarean section suffer significant postoperative pain. Transversus Abdominis Plane Block is an effective method of providing postoperative analgesia in patient undergoing lower segment caesarean section. We evaluated the efficacy of (0.25%) Bupivacaine and (0.5%) Ropivacaine for providing effective postoperative analgesia using TAPB in lower segment caesarean section. Material and Methods: Randomized controlled double blinded study was carried out in 90 female patients belonging to ASA grade 1 or 2, aged 20-35 years undergoing lower segment caesarean section. Patients were randomly allocated in two groups of 45 each (n=45). After all aseptic precautions patients were administered subarachnoid block bupivacaine heavy (0.5%) , 10mg, by 25G Whitacre spinal needle. After completion of surgery , they received TAP block with Group 1-0.5% ropivacaine (1.5mg/kg) Group 2-0.25% bupivacaine (1mg/kg) Patients were monitored for Visual Analogue scale (VAS) ,heart rate, blood pressure, SpO 2 , nausea ,vomiting, need of supplemental analgesia with in 24 hours. Results: After LSCS the Transversus Abdominis Plane Block with 0.5% ropivacaine reduced postoperative Visual Analog Scale pain scores compared to 0.25% Bupivacaine. Conclusion: 0.5% Ropivacaine provide better and long duration of analgesia as compared with 0.25% Bupivacaine and also decrease first 24 hours analgesic requirement postoperatively.

Effect of transversus abdominis plane block combined with low-dose dexmedetomidine on elderly patients undergoing laparoscopic colectomy

“…Ultrasonically, the patient’s anatomical structure, the entry of the puncture needle and the diffusion of anesthetic drugs can be directly observed, and the dosage of anesthetic drugs can be adjusted based on the actual situation of the patient, so that a better analgesic effect can be obtained, which not only lays a foundation for the smooth implementation of surgery, but also reduces the postoperative pain and helps shorten the recovery time of patients. Moreover, TAPB combined with low-dose dexmedetomidine can better prevent postoperative delirium [ 21 ]. In this study, the incidence rate of postoperative delirium in Group B (3.23%) was lower than that in Group A (22.58%) (χ 2 = 5.166, p = 0.023), and the duration of delirium in Group B ((0.76 ±0.31) days) was shorter than that in Group A ((2.05 ±0.68) days) ( t = 9.610, p < 0.001), suggesting that TAPB combined with low-dose dexmedetomidine has higher safety in elderly patients undergoing laparoscopic colectomy.…”