Effect of Adding Dexamethasone to Bupivacaine on Transversus Abdominis Plane Block [Transversus Abdominis Plane Bloga Eklenen Deksametazonun Etkisi]

Gülhaş, Nurçin; Kayhan, Gülay Erdoğan; Şanlı, Mukadder; Kitlik, Arzu; Durmuş, Mahmut

doi:10.5455/medscience.2015.04.8272

Cited by 6 publications

(8 citation statements)

References 19 publications

(18 reference statements)

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“…All 9 RCTs compared the TAP block using LA with dexamethasone versus LA alone. All studies used a long-acting LA for the TAP block, including bupivacaine in 3 studies [ 26 , 28 , 29 ], ropivacaine in 5 studies [ 16 , 17 , 24 , 25 , 30 ], and levobupivacaine in 1 study [ 27 ].…”

Section: Resultsmentioning

confidence: 99%

Clinical analgesic efficacy of dexamethasone as a local anesthetic adjuvant for transversus abdominis plane (TAP) block: A meta-analysis

Chen

Zhou

et al. 2018

PLoS ONE

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BackgroundPerineural dexamethasone has been shown to prolong the duration of local anesthetic (LA) effect in regional anesthesia; however, the use of perineural dexamethasone as an adjuvant to to the transversus abdominis plane (TAP) block remains controversial. This meta-analysis sought to assess the efficacy of dexamethasone in prolonging the TAP block and enhancing recovery after abdominal surgery.MethodsWe identified and analyzed 9 RCTs published on or before September 30, 2017, regardless of the original language, after searching the following 6 bibliographic databases: PubMed, EMBASE, Medline, Springer, Ovid, and the Cochrane Library. databases. These studies compared the effects of perineural dexamethasone mixed with local anesthetic versus local anesthetic alone in the TAP block. The Cochrane Collaboration’s Risk of Bias Tool was used to evaluate the methodological quality of each RCT. The primary outcomes were the time until the first request for postoperative analgesics and the analog pain scores at 2, 6, 12, and 24 h after surgery. The secondary outcomes were the analgesic consumption and the incidence of nausea and vomiting on the first day after surgery. We used Trial Sequential Analysis (TSA) to control for random errors.ResultsPerineural dexamethasone prolonged the duration of LA effect in the TAP block [mean difference (MD): 2.98 h; 95% confidence interval (CI): 2.19 to 3.78] and reduced analog pain scores at 2 h [MD: -1.15; 95% CI: -2.14 to -0.16], 6 h [MD: -0.97; 95% CI: -1.51 to -0.44], and 12 h [MD: -0.93; 95% CI: -1.14 to -0.72] postoperatively. Furthermore, the use of perineural dexamethasone was associated with less analgesic consumption [standard mean difference: -1.29; 95% CI: -1.88 to -0.70] and a lower incidence of nausea and vomiting [odds ratio: 0.28; 95% CI: 0.16 to 0.49] on the first day after surgery.ConclusionDexamethasone prolongs the LA effect when used as an adjuvant in the TAP block and improves the analgesic effects of the block.

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Section: Resultsmentioning

confidence: 99%

Clinical analgesic efficacy of dexamethasone as a local anesthetic adjuvant for transversus abdominis plane (TAP) block: A meta-analysis

Chen

Zhou

et al. 2018

PLoS ONE

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“…Considering our literature review, it can be stated that researchers generally apply unilateral TAP block for adult patients using 15-30 ml local anesthetic agents in varying concentrations [10][11][12][13]. Bupivacaine, ropivacaine, and levobupivacaine are usually preferred local anesthetic agents for TAP block [1,14].…”

Section: Discussionmentioning

confidence: 99%

“…Several adjuvant agents (including epinephrine, clonidine, buprenorphine, tramadol, dexamethasone, dexmedetomidine, neostigmine) are added to local anesthetics in regional and peripheral block applications to provide effective, long and safe analgesia at one time [9]. Only a few studies have investigated the addition of local anesthetics for TAP block such as dexamethasone [11], epinephrine [12], fentanyl [15], and dexmedetomidine [16,17]. Previous studies have reported significantly lower postoperative morphine consumption in the dexmedetomidine group [16,17].…”

Section: Discussionmentioning

confidence: 99%

Postoperative analgesic efficacy of ketamine added to bupivacaine in ultrasound guided transversus abdominis plane block for laparoscopic cholecystectomy

2020

Ann Clin Anal Med

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Aim: The aim of this study was to evaluate the efficacy of bupivacaine versus bupivacaine plus ketamine provided by Transversus Abdominis Plane (TAP) block for postoperative pain after elective laparoscopic cholecystectomy. Material and Method: A total of 120 patients were included in the study. The patients in Group B (n=60) received ultrasonography-guided bilateral subcostal TAP block with 20 ml of bupivacaine 1 mg kg-1 + 0.9% saline in each area, whereas the patients in Group BK (n=60) received bupivacaine 1 mg kg-1 with ketamine 0.5 mg kg-1 + 0.9% saline combination. Results: A total of 108 patients completed the study (Group B:53 and Group BK:55). In Group BK, postoperatively at 0, 2nd, 4th and 24th hours visual analog scale (VAS) scores at rest and 0, 2nd, 4th, 12th and 24th hours dynamic VAS scores were significantly lower than Group B (p<0.05). Moreover, in Group BK the time to first analgesic requirement was significantly later than in Group B (p<0.0001). We could not find any significant difference between the groups in terms of the total tramadol consumption. Discussion: We conclude that TAP block with bupivacaine plus ketamine rather than bupivacaine alone increases the time until the first request for rescue analgesia and lowers pain scores after laparoscopic cholecystectomy.

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“…8 Penambahan deksametason pada anestetik lokal telah dilakukan pada beberapa penelitian yang membuktikan bahwa waktu kebutuhan analgesik pertama lebih panjang dan skor nyeri lebih rendah pada grup deksametason dibanding dengan grup kontrol. 3,9 Penelitian ini bertujuan untuk membandingkan waktu kebutuhan analgesik pertama dan skor nyeri antara blok TAP panduan ultrasonografi memakai bupivakain 0,25% dengan kombinasi bupivakain 0,25% dan deksametason 8 mg.…”

Section: Pendahuluanunclassified

“…Hal ini sejalan dengan beberapa penelitian lain yang menunjukkan waktu kebutuhan analgesik pertama lebih panjang pada blok TAP kombinasi bupivakain dan deksametason dibanding dengan bupivakain. 3,9 Vasokonstriksi dapat terjadi karena efek glukokortikoid dalam memengaruhi reaktivitas vaskular dengan cara menghambat produksi vasodilator seperti prostasiklin dan nitric oxide, potensiasi respons vasoaktif terhadap katekolamin melalui reseptor glukokortikoid, serta meningkatkan respons kortisol yang berhubungan dengan peningkatan sensitivitas kontraksi arteri. 15 Efek vasokonstriksi tersebut menyebabkan penurunan absorpsi sistemik sehingga terjadi pemanjangan waktu blok saraf oleh anestetik lokal.…”

Section: Pembahasanunclassified

Perbandingan Bupivakain 0,25% dengan Kombinasi Bupivakain 0,25% dan Deksametason 8 mg pada Blok Transversus Abdominis Plane dengan Panduan Ultrasonografi sebagai Analgesia Pascahisterektomi

Delis¹,

Pradian²,

Yadi³

2018

jap

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Analgesia dinding abdomen anterior dan lateral dapat dilakukan dengan blok transversus abdominis plane (TAP). Penelitian ini bertujuan menilai waktu kebutuhan analgesik pertama dan skor nyeri 2, 4, 6, 12, 24 jam pascahisterektomi antara bupivakain 0,25% dengan kombinasi bupivakain 0,25% dan deksametason 8 mg pada blok TAP. Penelitian menggunakan uji klinis acak terkontrol buta tunggal, dilakukan di Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung pada bulan Oktober-Desember 2017. Pasien dibagi menjadi grup bupivakain 0,25% (grup B, n=20) dan grup kombinasi bupivakain 0,25% deksametason 8 mg (grup BD, n=20). Uji statistik menggunakan uji-t berpasangan, Uji Wilcoxon, dan uji chi-square. Hasil penelitian mengungkapkan waktu kebutuhan analgesik pertama lebih lama pada grup BD (866,45±98,11 menit) dibanding dengan grup B (352,75±43,32 menit) dengan perbedaan signifikan (p<0,05). Median skor nyeri pascahisterektomi grup BD pada 4 jam (1), 6 jam (2), 12 jam (2), dan 24 jam (2) lebih rendah dibanding dengan grup B dengan median skor nyeri 4 jam (2), 6 jam (3), 12 jam (4), dan 24 jam (3), dengan perbedaan signifikan (p<0,05). Simpulan penelitian ini adalah kombinasi bupivakain 0,25% dan deksametason 8 mg pada blok TAP menghasilkan waktu kebutuhan analgesik pertama lebih lama dan skor nyeri pascahisterektomi lebih rendah dibanding dengan bupivakain 0,25%. Kata kunci: Blok transversus abdominis plane, deksametason, skor nyeri, waktu kebutuhan analgesik pertama Comparison between 0.25% Bupivacaine and Combination of 0.25% Bupivacaine and 8 mg Dexamethasone on Transversus Abdominis Plane Block Ultrasound-guided as Post-Hysterectomy Analgesia

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Effect of Adding Dexamethasone to Bupivacaine on Transversus Abdominis Plane Block [Transversus Abdominis Plane Bloga Eklenen Deksametazonun Etkisi]

Abstract: Abstract

Cited by 6 publications

References 19 publications

Clinical analgesic efficacy of dexamethasone as a local anesthetic adjuvant for transversus abdominis plane (TAP) block: A meta-analysis

Clinical analgesic efficacy of dexamethasone as a local anesthetic adjuvant for transversus abdominis plane (TAP) block: A meta-analysis

Postoperative analgesic efficacy of ketamine added to bupivacaine in ultrasound guided transversus abdominis plane block for laparoscopic cholecystectomy

Perbandingan Bupivakain 0,25% dengan Kombinasi Bupivakain 0,25% dan Deksametason 8 mg pada Blok Transversus Abdominis Plane dengan Panduan Ultrasonografi sebagai Analgesia Pascahisterektomi

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