Evaluation of Dexmedetomidine as an Adjuvant to Ropivacaine in Transversus Abdominis Plane Block for Postoperative Analgesia in Unilateral Infraumbilical Surgeries-A Randomized Prospective Trial.

ABSTRACT

BACKGROUND: Transversus abdominis plane (TAP) block has been demonstrated to be an effective module of multimodal analgesic treatments for infra-umbilical surgeries with limited duration of action. Various adjuvants have been studied to increase the efficacy of this technique. Herein, we evaluated the analgesic efficacy of dexmedetomidine with ropivacaine in TAP block for unilateral infra-umbilical surgeries under spinal anesthesia. METHODS: The study was conducted on 60 adult patients with the age of 18-65 years, who were planned for unilateral infra-umbilical surgeries under spinal anesthesia. These patients are randomly divided into 2 groups (30 each). In group A, 20 mL of 0.25% ropivacaine with 1 mL of normal saline, and in group B, 20 mL of 0.25% ropivacaine with 0.5 µg/kg (1 mL) dexmedetomidine was given in ultrasound-guided TAP block. Duration, quality of analgesia, and total analgesic consumption were noted. Statistical analysis was performed with SPSS software version 21.0 (IBM Corp., Armonk, NY, USA) by using Student's t-test and chi-square test. RESULTS: The mean duration of analgesia was significantly longer in group B than group A (842.50 ± 38.74 min and 435.17 ± 25.75 min, respectively). Verbal numerical rating scale was persistently low in both groups, except at the 7th hour and 20th hour in group A and the 12th hour in group B. Total analgesic consumption and number of analgesics doses during 24 hours after surgery were also lower in group B. CONCLUSIONS: The addition of dexmedetomidine as adjuvant to 0.25% ropivacaine for TAP block significantly increases the duration and quality of analgesia without any significant adverse effects.