Effect of addition of dexamethasone to ropivacaine on post-operative analgesia in ultrasonography-guided transversus abdominis plane block for inguinal hernia repair: A prospective, double-blind, randomised controlled trial

Abstract

Background and Aims:Ultrasonography (USG)-guided transversus abdominis plane (TAP) block is an abdominal field block with high efficacy. This study was undertaken with the aim of determining the effect of the addition of dexamethasone to 0.5% ropivacaine on post-operative analgesia in USG-guided TAP block for inguinal hernia repair.Methods:A double-blind randomised control study was conducted on sixty patients posted for inguinal hernia repair with the American Society of Anesthesiologists physical Status I or II, who were allocated two groups of 30 each. Patients in Group RS received 0.5% ropivacaine (20 ml) and normal saline (2 ml) whereas patients in Group RD received 0.5% ropivacaine (20 ml) and dexamethasone (2 ml, i.e., 8 mg), in USG-guided TAP Block on the same side, after repair of inguinal hernia under spinal anaesthesia. Visual analogue scale (VAS) scores, time for request of first analgesia and total tramadol consumption in first 24 h were compared. Unpaired Student's t-test and Mann–Whitney U-test were performed using SPSS 23 Software.Results:Patients in Group RD had significantly lower VAS scores as compared to Group RS from 4th to 12th h, postoperatively. Duration of analgesia was significantly more in Group RD (547.50 [530,530] min) when compared with Group RS (387.50 [370,400] min) (P < 0.001). The demand for intravenous tramadol was significantly low in Group RD (223.33 ± 56.83 mg) as compared to Group RS (293.33 ± 25.71 mg) (P < 0.001).Conclusion:Addition of dexamethasone to ropivacaine in USG-guided TAP block significantly reduces post-operative pain and prolongs the duration of post-operative analgesia, thereby reducing analgesic consumption.

Addition of dexmedetomidine to ropivacaine in subcostal transversus abdominis plane block potentiates postoperative analgesia among laparoscopic cholecystectomy patients: A prospective randomized controlled trial

“…have reported that the addition of dexamethasone to ropivacaine in ultrasonography (USG)-guided TAP block prolongs postoperative analgesia and reduces analgesic consumption. [ 16 ] Metwally et al . have reported that the addition of fentanyl to the local anesthetic in USG-guided TAP block prolongs the analgesia, lowers postoperative pain score and reduces the opioid consumption.…”

Comparative evaluation of ropivacaine and ropivacaine with dexamethasone in transverse abdominis plane block for lower abdominal surgeries: a prospective, randomized, double-blinded study

“…Since the above studies were done under subarachnoid block, early postoperative pain assessment could be misleading. [ 12 ]…”

“…There were also variations in the pain scores with the dose of local anesthetics and dexamethasone used in the previous studies. [ 11 12 13 14 15 ] Whether the difference in the onset of analgesia was due to increased local anesthetic concentration or dexamethasone was not evident. Moreover, for surgeries done under subarachnoid block, the early pain score assessment could also be misleading.…”

“…Moreover, for surgeries done under subarachnoid block, the early pain score assessment could also be misleading. [ 11 12 ]…”

“…Most of the studies involving dexamethasone for TAP block were done on specific surgeries. [ 11 12 13 14 15 16 17 18 ]…”