Ultrasound-guided transversus abdominis plane block: What are the benefits of adding dexmedetomidine to ropivacaine?

Mishra, Manjaree; Mishra, Shashi Kant; Singh, Somendra Pal

doi:10.4103/1658-354x.197348

Cited by 15 publications

(10 citation statements)

References 13 publications

(12 reference statements)

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“…Our results also match with Aksu et al and Mishra et al who observed that sedation was non-significantly higher in the patients who received dexmedetomidine in addition to bupivacaine. 18,19 We found that the patients satisfaction was non significantly higher in the patients who received dexmedetomidine in addition to bupivacaine in comparison to other groups. Such findings have also been reported previously by Aksu et al and Mishra et al 18,19 We observed that heart rate, systolic and diastolic BP was better maintained in BDX except decrease in heart rate at 2 hours was for very short time, and it can be explained by bradycardia causing property of alpha 2 agonist.…”

Section: Resultsmentioning

confidence: 79%

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

Thakur¹,

Gupta²,

Gupta³

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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Background: Caesarean section is most frequently performed surgery worldwide. Patients experience moderate to severe pain in the first 48 hours post-operatively. Aim of this study was to evaluate the efficacy of dexmedetomidine and dexamethasone as an adjunct to bupivacaine in ultrasound guided TAP block for postoperative analgesia in patients of caesarean section.Methods: A total 120 ASA I and II patients undergoing elective and emergency caesarean section under subarachnoid block were randomly divided into three groups B, BDM, BDX to receive bupivacaine alone or dexmedetomidine or dexamethasone as an adjunct to bupivacaine in ultrasound guided TAP block. Postoperatively, the patients were evaluated for pain level at rest and on movement with a 10 cm visual analog scale (VAS) pain score (0 = no pain and 10 = worst pain), time to demand of first analgesic request, number of analgesic requirements, nausea or vomiting, sedation and patient satisfaction at 0 hours and at 2, 4, 6, 12, 18, and 24 hours.Results: VAS score was significantly higher in group B in comparison to BDM and BDX, and higher in BDX in comparison to group BDM. Mean duration of analgesia was significantly higher in group BDM in comparison to group B and BDX. Total number of rescue analgesic demands were significantly lower in group BDM in comparison to group B and BDX. Sedation score and satisfaction score was higher in group BDM as compared to group B and BDX.Conclusions: Addition of dexmedetomidine and dexamethasone as an adjunct to bupivacaine reduces postoperative pain, prolongs analgesia, decreases demand for additional analgesics and provides better maternal satisfaction as compared to plain bupivacaine group in TAP block in patients undergoing caesarean section under subarachnoid block. Among dexmedetomidine and dexamethasone, dexmedetomidine had prolonged analgesia as compared to dexamethasone group.

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Section: Resultsmentioning

confidence: 79%

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

Thakur¹,

Gupta²,

Gupta³

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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“…Dexmedetomidine is a selective α2-adrenoreceptor agonist and when administered IV, provides analgesia and sedation without causing respiratory depression [15]. Studies have shown that the addition of dexmedetomidine to local anesthetics in central and peripheral blocks is effective in potentiating the local anesthetic effect and decreasing the need for analgesia [16][17][18]. In a study by McDonnell et al [19], complete regression of the sensory deficit caused by a TAP block was observed after 24 hrs.…”

Section: Discussionmentioning

confidence: 99%

“…Various adjuvants have been described to prolong the sensory block and these are used in daily clinical practice. In previous studies in the literature, dexmedetomidine has been used at a dose of bilateral 1 mcg/kg as appropriate for TAP block [ 15 , 17 , 18 ]. The dose used in the current study was the same as that in the literature.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Transversus Abdominis Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy: A Retrospective Study

Karasu

Yılmaz

Özgünay

et al. 2020

North Clin Istanbul

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Ultrasound-guided transversus abdominis plane block for postoperative analgesia in laparoscopic cholecystectomy: A retrospective study Orıgınal Article ANESTHESIOLOGY&REANIMATION Cite this article as: Karasu D, Yilmaz C, Ozgunay SE, Yalcin D, Ozkaya G. Ultrasound-guided transversus abdominis plane block for postoperative analgesia in laparoscopic cholecystectomy: A retrospective study. North Clin Istanb UNCORRECTED PROOF M any methods such as patient-controlled thoracic epidural analgesia, intravenous patient-controlled analgesia, the intraperitoneal injection of local anesthetics, non-steroidal anti-inflammatory drugs, opioids, and multimodal analgesia have been used for postoperative pain after laparoscopic cholecystectomies [1, 2]. Rafiin was first described transversus abdominis plane (TAP) block in 2001 and the TAP block provides up to 24 hours of analgesia [3]. Local anesthetics administration between the T6-L1 spinal nerve roots alleviates pain in abdominal procedures [4]. Improvements have made to TAP with the addition of ultrasound guidance, to confirm the proper region and avoid complications [4]. Ultrasonography (USG) guided techniques may have the advantage of being effective and safe through direct needle visualization [5]. Bupivacaine, ropivacaine, and ABSTRACT OBJECTIVE: This study aimed to investigate the effect on postoperative pain of ketamine and dexmedetomidine addition to bupivacaine in a transversus abdominis plane (TAP) block in laparoscopic cholecystectomy. METHODS: A retrospective study was carried on patients who underwent ultrasound-guided TAP block in laparoscopic cholecystectomy. The patients were divided into three groups: Group BD (Bupivacaine+Dexmedetomidine), Group BK (Bupi-vacaine+Ketamine), and Group B (Bupivacaine). Our primary outcomes were pain scores with Visual Analogue Scale (VAS), postoperative first analgesic time and tramadol consumption in 24 hours postoperatively. Secondary outcomes were intraoperative hemodynamic changes, rescue analgesic requirement and side effects. RESULTS: The first analgesic administration time was significantly shorter in Group B, and significantly longer in Group BD than the other two groups. Pain score at rest in Group B at 0 th hours was significantly higher than that of Group BD and VAS pain score Group BD at 2 nd hours was significantly lower than the other 2 groups. There was no significant difference between the groups regarding tramadol consumption and the requirement of rescue analgesics. CONCLUSION: Dexmedetomidine and ketamine can be added to the bupivacaine for the TAP block without major side-effects. The combination of dexmedetomidine and bupivacaine provides better analgesia in the first postoperative 2 nd hour compared to other groups and hence extends the time to the first analgesic demand.

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“…Inadequate postoperative analgesia can lead to several undesirable effects, such as patient’s discomfort, thromboembolism due to prolonged immobility and reduced pulmonary clearance leading to complications ( 3 ). Among several modalities available ( 4 ), transverse abdominis plane (TAP) block is a simple and efficient modality for pain relief in patients undergoing laparoscopic appendicectomy ( 5 – 8 ). Several studies have shown that TAP block is perfectly suited for use after lower abdominal and gynaecological surgeries ( 8 , 9 ).…”

Section: Introductionmentioning

confidence: 99%

“…Among several modalities available ( 4 ), transverse abdominis plane (TAP) block is a simple and efficient modality for pain relief in patients undergoing laparoscopic appendicectomy ( 5 – 8 ). Several studies have shown that TAP block is perfectly suited for use after lower abdominal and gynaecological surgeries ( 8 , 9 ). Being a highly selective α2 agonist ( 10 ), the use of dexmedetomidine with local anaesthetic (LA) agents prolongs the LA effect, thus prolonging postoperative analgesia ( 11 – 13 ).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Dexmedetomidine as an Adjuvant to Bupivacaine in UltrasoundGuided Transverse Abdominis plane Block for Laparoscopic appendicectomy: A Randomised Controlled Study

Neethirajan

Kurada

Parameswari

2020

Turk J Anaesthesiol Reanim

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Objective Dexmedetomidine is an alpha 2-adrenergic agonist that prolongs analgesia as an adjuvant when added in neuraxial and peripheral nerve blocks. The aim of the present study was to evaluate the efficacy of dexmedetomidine as an adjuvant to bupivacaine in ultrasound (USG)-guided transverse abdominis plane (TAP) block for postoperative analgesia in laparoscopic appendicectomy. Methods A total of 60 American Society of Anesthesiologists I and II adult patients aged between 16 and 60 years planned for laparoscopic appendicectomy were randomised into two groups (A and B). Group A patients received 20 mL of 0.125% bupivacaine+1 μg kg −1 dexmedetomidine, whereas group B patients received 20 mL of 0.125% bupivacaine alone on both sides at the time of USG-guided TAP block. Haemodynamic variables, pain scores, sedation scores, time to first dose of rescue analgesic and side effects, if any, were assessed and compared between the groups. Results Demographic and operative characteristics were comparable in both groups. The mean duration of analgesia was more in group A (7.33 h) than in group B (4.8 h). The requirement of rescue analgesics was more in group B (80%) than in group A (56.7%). The sedation and pain scores at 2, 4 and 6 h were better in group A than in group B (p<0.05). The heart rate, systolic blood pressure and diastolic blood pressure were lower in group A during the postoperative period than in group B. Conclusion The addition of dexmedetomidine as an adjuvant to bupivacaine in TAP block provides prolonged postoperative analgesia and better pain control with reduced need for rescue analgesics than bupivacaine alone in patients undergoing laparoscopic appendicectomy.

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Ultrasound-guided transversus abdominis plane block: What are the benefits of adding dexmedetomidine to ropivacaine?

Cited by 15 publications

References 13 publications

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

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

Ultrasound-Guided Transversus Abdominis Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy: A Retrospective Study

Efficacy of Dexmedetomidine as an Adjuvant to Bupivacaine in UltrasoundGuided Transverse Abdominis plane Block for Laparoscopic appendicectomy: A Randomised Controlled Study

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