To Evaluate The Effect Of Addition Of Dexmedetomidine to Ropivacaine in TransversusAbdominis Plane Block on Post-Operative Analgesia After Caesarean Section- A Randomized Double Blind Study.
Post-Operative Analgesia After Caesarean Section
Background: Studies have demonstrated the efficacy of Transverses abdomen plane (TAP) block as a component of multimodal postoperative analgesia after cesarean section. The aim of the present study was to compare the efficacy of combination of dexmedetomidine and ropivacaine to ropivacaine alone for Transversusabdominis plane (TAP) block as post-operative analgesic after lower segment cesarean section (LSCS). Subjects and Methods: A randomized double blind, prospective study was conducted on 100 ASA grade I and II pregnant patients undergoing LSCS under spinal anesthesia. They were randomly divided into two groups, group I (n=50) received 20 ml of ropivacaine 0.25% and 2 ml of normal saline while group II (n=50) received 0.5 mcg/kg dexmedetomidine dissolved in 2 ml of normal saline and 20 ml of ropivacaine 0.25% as bilateral TAP block at the end of surgery. The total duration of effective analgesia was recorded as primary outcome and secondary outcomes were pain score, total requirement of analgesics in the first 24hrs postoperatively and side effects. Results: The time for first analgesic dose was longer in group I than group II (282.58 vs 192.2 min, p<0.05) and total dose of Tramadol used in the first 24 hrs was less among patients in group II when compared with those in group I (72 vs. 98 mg, p<0.05). Pain was significantly reduced at all post-operative points for the first 6 hrs in group II compared with group I (p<0.05). Changes in systolic, diastolic and mean arterial pressure and heart rate were statistically insignificant in both groups. There was no statistically significant difference in the incidence of side effects in both groups. Conclusion: In conclusion, this study shows that addition of dexmedetomidine to ropivacaine for TAP block after cesarean section, achieves better analgesia and provides longer duration of pain control post-operatively without any major side-effects.