Efficacy of Perineural versus Systemic Dexamethasone to Prolong Analgesia after Ultrasound Guided TAP Block for Patients Undergoing Lower Abdominal Surgeries

Abstract

Abstract Background Poorly controlled acute pain after surgery is associated with a variety of unwanted postoperative consequences, including patient suffering, distress, myocardial ischemia, prolonged hospital stay and increase of chronic pain. Aim of the Work to study the effect of adding dexamethasone perineurally & systemicly as an adjuvant to bupivacaine in TAP block. The comparison included the effect on postoperative pain & postoperative analgesic requirement and haemodynamics. Patients and Methods In our study, 52 patients were randomly divided into two equal groups: Group A: Patients who received 2 ml volume of dexamethasone (8 mg) perineurally combined with the 20 ml of bupivacaine of (0.25%) concentration in the block (total 22 ml), followed by injecting 5 ml saline intravenous. Group B: Patients who received 2 ml of dexamethasone (8 mg) intravenously diluted over 3 cm saline in a 5 ml syringe intravenously following injection of the perineural 20 ml bupivacaine (0.25%) combined with 2 ml saline to have the same syringe volume for the block (22 ml) Results Our study showed that addition of dexamethasone to bupivacaine in TAP block whether perineural or intravenous prolonged postoperative analgesia with negligible side effects & better outcome to the perineural route. Conclusion Addition of perineural dexamethasone to bupivacaine in TAP block provided adequate post operative analgesia & patient satisfaction along with reduced numbers of rescue analgesia doses. Dexamethasone was seen to be a potent adjunct to local anaesthetic to prolong post operative analgesia with negligible side effects & better outcome to the perineural route.