Abstract
BackgroundNinety patients American Society of Anesthesiologists (ASA) I–II, aged (18–60 years), were enrolled in this randomized controlled trial. All enrolled patients had undergone elective primary unilateral open inguinal hernia repair under spinal anesthesia; at the end of the surgery, transversus abdominis plane (TAP) block was done by bupivacaine combined with 4 mg dexamethasone in (group I), 8 mg dexamethasone in (group II), or saline in (group III.). We aimed to compare the analgesic efficacy of two different doses of dexamethasone (4 mg and 8 mg) added to bupivacaine in a unilateral single-injection (TAP) block. The first outcome measure was the time of the first analgesic request, and the secondary outcome measure was the VAS scale in the first postoperative 24 h.ResultsThere was no need for any analgesia in group I and group II in the first postoperative 24 h. The time of the first analgesic request in group III was 720 ± 90 min. VAS scores were significantly lower in group I and group II than in group III, with no significant difference between group I and group II.ConclusionsThere is no difference in the first postoperative 24 h analgesic effect of the two doses of dexamethasone when added to a long-acting local anesthetic mixture in TAP blocks in patients undergoing inguinal hernia repair.Trial registrationClinicalTrials.gov, NCT03863977
Highlights
Ninety patients American Society of Anesthesiologists (ASA) I–II, aged (18–60 years), were enrolled in this randomized controlled trial
Dexamethasone is commonly used as an adjuvant to local anesthetics in transversus abdominis plane (TAP) block to prolong the duration of the block (Ammar and Mahmoud 2012; Akkaya et al 2014; Yildiz and Bayir 2015)
We used the injection of either 4 mg dexamethasone added to 1 mg/kg of 0.5% bupivacaine in, 8 mg dexamethasone added to 1 mg/kg of 0.5% bupivacaine, or 1 mg/kg of 0.5% bupivacaine in the control group; the study drugs were prepared by an independent researcher in syringes with an equal volume (25 ml) of the study solutions, and he put them in coded envelopes according to the randomization order and the anesthesiologist opened the envelopes just before the injection
Summary
Ninety patients American Society of Anesthesiologists (ASA) I–II, aged (18–60 years), were enrolled in this randomized controlled trial. Abdel-wahab et al Ain-Shams Journal of Anesthesiology (2021) 13:20 mg and no one of them identified the ideal effective dose (Ammar and Mahmoud 2012; Akkaya et al 2014; Yildiz and Bayir 2015; Wegner et al 2017; Deshpande et al 2017; Kartalov et al 2015), so we planned this study to identify is there any difference in the postoperative analgesic effect of the two commonly used doses of dexamethasone (4 mg and 8 mg) (Chen et al 2018), added to bupivacaine in ultrasound-guided TAP block for inguinal hernia repair
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