Management of post operative pain remains one of the most important issue after surgery. Postoperative pain in lower abdominal surgeries, its management and complications is a challenge to anesthesiologist. Dexmedetomidine is a valuable adjuvant analgesic which can sufficiently prolong the duration of analgesia given in nerve blocks. We studied the effect of addition of dexmedetomidine to bupivacaine compared with bupivacaine alone in ultrasound guided transversus abdominis plane block in patients undergoing lower abdominal surgeries.
Methods: A total of 60 PATIENTS scheduled for lower abdominal surgeries divided into two equal groups in a randomized double blinded way. Group B received Transversus abdominis block with 20 ml bupivacaine (0.25%) - 30 patients.
Group BD -20 ml bupivacaine (0.25%) with dexmedetomidine (0.5mcg/kg) - 30 patients bilaterally. Base line Pulse rate, Blood pressure, Respiratory rate, Spo2, Duration of analgesia, Onset of pain by Visual analog scale(VAS), Ramsay sedation scale, Post operative pulse rate, Blood pressure, Respiratory rate, Spo2, dose of rescue analgesia used were noted.
Results: The time interval for requirement of first dose of rescue analgesia was prolonged in BD group [mean analgesic duration-488 min] than the B group [mean analgesic duration-290 min]. The total dose of rescue analgesic usage is decreased in group BD with injection Tramadol a mean dose of 65.00 mg and 183.33 mg in group B in the first 12hr among BD group there was a significant reduction in dose of rescue analgesia needed. It was also observed decreased opioid usage and hence the decreased side effects of it like pruritus, vomiting and nausea.