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Indian Journal of Anesthesia and Analgesia

Volume  6, Issue 6, November-December 2019, Pages 2168-2175
 

Original Article

Comparative Assessment of Analgesic Efficacy of TAP Block with Dexmedetomidine, Ropivacaine and with Ropivaciane Alone in Open Open Lower Abdominal Gynecological Surgeries

Priyanka Agarwal, Purvashree Deshmukh, Chaitanya Kamat, Ravi Kerur, Meghana Hanagandi, Guruprasad Shetty

1Senior Registrar, Department of Anesthesia, Vivekananda Institute of Medical Sciences, Ramakrishna Mission Seva pratisthan, Kolkata, West Bengal 700026, India. 2,4,5,6Assistant Professor, 3Associate Professor, Department of Anesthesiology, Jawaharlal Nehru Medical College, KAHER and Dr. Prabhakar Kore Hospital, Belagavi, Karnataka 590010, India.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6619.46

Abstract

Background: Transversus Abdominis Plane (TAP) block is a simple and unique method for regional analgesia, especially for lower abdominal surgeries. The aim of this study was to compare the analgesic efficacy of TAP block on addition of 0.5 mcg/kg Dexmedetomidine to 0.2% Ropivacaine and 0.2% Ropivacaine alone in lower abdominal gynecological surgeries. Patients and Methods: Total of 60 female patients, scheduled for open lower abdominal surgery under general anesthesia, were recruited into two Groups: Ropivacaine (R) and Ropivacaine and Dexmedetomidine (RD). Group R received USG-guided TAP block with 30 ml of 0.2% Ropivacaine and saline. Group RD received USG-guided TAP block with 30 ml of 0.2% Ropivacaine and 0.5 mcg/kg of Dexmedetomidine. Post-operative pain scores, sedation score, time to first rescue analgesic, and total opioid requirement in first 24 hours, were calculated. Results: The difference between the duration of time to first rescue analgesic, between two groups, was statistically significant (p = 0.018). Further, it was observed that the VAS scoring was lower in group RD as compared to Group R, at al. the time intervals. The RD Group showed a significant difference between Modified Wilsons sedation score at first hour in both the groups, p < 0.001. All the patients in both the groups were oriented without sedation and with statistical significance (p < 0.05). Conclusion: The analgesic efficacy of Dexmedetomidine with 0.2% Ropivacaine in TAP block showed a positive result when compared to 0.2% Ropivacaine alone. The analgesic efficacy of Dexmedetomidine with 0.2% Ropivacaine was more pronounced when compared to the 0.2% Ropivacaine individually in TAP block procedure during Lower Abdominal Gynecological Surgeries.


Keywords : Analgesia; Dexmedetomidine; Ropivacaine; TAP block.
Corresponding Author : Chaitanya Kamat