Effect of Perineural dexamethasone as additive to bupivacaine on transverse abdominal plane block for post-operative analgesia in elective cesarean section under spinal anesthesia
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Date
2019-05
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Addis Abeba University
Abstract
Background: The transverses abdominal plane (TAP) block is straightforward regional technique
used for postoperative analgesia in patients undergoing lower abdominal surgeries. Dexamethasone
is steroid which is mostly used drug as adjuvant or additive in most of regional block in order tintensify quality and prolong the block.
Objective: To assess effect of Perineural dexamethasone as additive to bupivacaine on transversabdominal plane block for post-operative analgesia in elective cesarean section under spina
anesthesia at black lion specialized hospital.
Methodology: An institutional based prospective cohort study was conducted on 58 patientStudy participants were selected by systematic random sampling technique. Data collection
methods include preoperative chart review, intraoperative observation and postoperative patient
interview starting at 2, 4, 6, 12 and 24 postoperatively. Demographic data were analyzed usinstudent t test and Chi square and Fisher’s exact test. Mann –Whitney U test was used to comparthe pain severity, first analgesia request time as well as analgesic consumption between the groups
in the postoperative time for 24 hours. Chi-square test was used to analyze the homogenous
categorical variables and a p-value less than 0.05 was considered as statistically significant.
Result: This study found that TAP D has prolonged time to first analgesia request with a mediaduration of 8.5 hours compared to 5.5 hours in TAP A (alone) (p<0.001). The total analgesi
consumption was lower in TAP D group with a median total dose of 50mg compared with 100 min TAP A group with statistically significant difference within 24 hours (p<0.003). Also, reducethe pain score in TAP D group, being statically significant at 6th, 12th and 12th hr.
Conclusion and Recommendation: We found Perineural dexamethasone as additive on TAPdecrease postoperative pain severity, total analgesic consumption and prolong the duration of
analgesia. Based on our finding we recommend the use of Perineural dexamethasone as additive on
TAPB as effective postoperative analgesia in our setup.
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Keywords
Perineural dexamethasone with transverse abdominal block, transverse abdominal plane block.