Addition of dexmedetomidine to bupivacaine in Transversus Abdominis Plane Block in Inguinal Hernia Repair: A Perspective Double Blind Study

Abstract

BACKGROUND Dexmedetomidine an α 2 adrenergic agonist is well known for potentiating the effect of local anaesthetics in neuraxial blockade and peripheral nerve blocks. It prolongs the duration of analgesia produced by local anaesthetic, as well as reduces the dose of local anaesthetic required to produce the block. This helps in early mobilization and recovery of the patient. We conducted this study to access the effect of adding dexmedetomidine to bupivacaine in transversus abdominis plane (TAP) block in inguinal hernia repair. METHODS 60 patients posted for inguinal hernia repair were divided into two groups of 30 each in randomized double-blind manner. Group B patients (n=30) received 20 ml of 0.25% of bupivacaine and 2ml normal saline for TAP block whereas Group D received 20 ml 0.25% bupivacaine and 0.5 µgm/Kg of dexmedetomidine (2 ml). NPRS scores for postoperative pain, time to request for first analgesic dose, total duration of analgesia, Inj. Diclofenac consumption, haemodynamic parameters and side effects were recorded. RESULTS Numerical pain rating scale scores were significantly lower in group D. Total analgesic requirement was significantly less in group D. Time to request for first analgesic dose was longer in group D as compared to group B. Patients were haemodynamically stable in both the groups. CONCLUSIONS The addition of dexmedetomidine to bupivacaine in TAP block provides prolonged and effective postoperative analgesia with haemodynamic stability.