Analgesic Efficacy of Inj. Dexamethasone (8mg) with Inj. Levobupivacaine (0.25%) in Ultrasound-Guided Transverse Abdominis Plane (TAP) Block after Caesarean Delivery
Authors/Creators
- 1. Associate Professor, Department of Anesthesia, Government Medical College, Vadodara, Gujarat.
- 2. Assistant Professor, Department of Anesthesia, Government Medical College, Vadodara, Gujarat.
- 3. Senior Resident, Department of Anesthesia, Government Medical College, Vadodara, Gujarat.
- 4. Ex. Resident, Department of Anesthesia, Government Medical College, Vadodara, Gujarat.
- 5. Resident Doctor, Department of Anesthesia, Government Medical College, Vadodara, Gujarat.
Description
For several lower abdominal surgeries, including caesarean sections post-operatively, ultrasound-guided Transverse Abdominis Block (TAPB) is a safe and effective analgesic technique. To find the most effective analgesic combination, various drug combinations have been tested. Levobupivacaine and adjuvants like dexamethasone added to local anesthetics in TAPB have been shown to lessen postoperative pain intensity during the postoperative period. Our study aimed to assess the efficacy of the addition of Inj. Dexamethasone (8mg) to Inj. Levobupivacaine (0.25%) in USG guided transverses abdominis plane block given in patients who underwent cesarean section. A total of 80 patients (40 per group) posted for elective and emergency caesarean delivery were included in the present study. Grouping of the patient was done by sealed envelope method & divided into two groups:1). Group L: TAP block with 30 ml of Inj. Levobupivacaine 0.25% + 2cc Normal saline total of 32cc.[16 ml on each side],2). Group LD: TAP block with 30 ml of Inj. Levobupivacaine 0.25% + Inj. Dexamethasone 8 mg (2ml) total of 32 ml. [16ml on each side] and the time to first rescue analgesia (Vas score > 4), the total amount of rescue analgesia required in the first 24 h postoperatively were recorded. We observed that the Time to first rescue analgesia was prolonged significantly in the group LD (19.9hrs ± 2.07) compared to group L (10.2hrs ± 2.21) (p <0.0001). Visual analogue scale scores were significantly lower in group LD. The total consumption of Inj. Diclofenac Sodium in 24hrs was significantly lower in the group LD (95.6 ± 33.92) compared to group L(170.6mg ± 50.92) (p<0.0001). Thus in conclusion, In USG-guided TAPB, the addition of dexamethasone (8 mg) to Levobupivacaine (0.25%) considerably lessens post-operative pain and extends the duration of postoperative analgesia, lowering the requirement for overall analgesics consumption.
Abstract (English)
For several lower abdominal surgeries, including caesarean sections post-operatively, ultrasound-guided Transverse Abdominis Block (TAPB) is a safe and effective analgesic technique. To find the most effective analgesic combination, various drug combinations have been tested. Levobupivacaine and adjuvants like dexamethasone added to local anesthetics in TAPB have been shown to lessen postoperative pain intensity during the postoperative period. Our study aimed to assess the efficacy of the addition of Inj. Dexamethasone (8mg) to Inj. Levobupivacaine (0.25%) in USG guided transverses abdominis plane block given in patients who underwent cesarean section. A total of 80 patients (40 per group) posted for elective and emergency caesarean delivery were included in the present study. Grouping of the patient was done by sealed envelope method & divided into two groups:1). Group L: TAP block with 30 ml of Inj. Levobupivacaine 0.25% + 2cc Normal saline total of 32cc.[16 ml on each side],2). Group LD: TAP block with 30 ml of Inj. Levobupivacaine 0.25% + Inj. Dexamethasone 8 mg (2ml) total of 32 ml. [16ml on each side] and the time to first rescue analgesia (Vas score > 4), the total amount of rescue analgesia required in the first 24 h postoperatively were recorded. We observed that the Time to first rescue analgesia was prolonged significantly in the group LD (19.9hrs ± 2.07) compared to group L (10.2hrs ± 2.21) (p <0.0001). Visual analogue scale scores were significantly lower in group LD. The total consumption of Inj. Diclofenac Sodium in 24hrs was significantly lower in the group LD (95.6 ± 33.92) compared to group L(170.6mg ± 50.92) (p<0.0001). Thus in conclusion, In USG-guided TAPB, the addition of dexamethasone (8 mg) to Levobupivacaine (0.25%) considerably lessens post-operative pain and extends the duration of postoperative analgesia, lowering the requirement for overall analgesics consumption.
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IJTPR,Vol13,Issue4,Article9.pdf
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Additional details
Dates
- Accepted
-
2023-03-27
Software
References
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