ULTRASOUND-GUIDED TRANSVERSE ABDOMINIS PLANE BLOCK WITH ROPIVACAINE OR ROPIVACAINE WITH DEXAMETHASONE FOR POSTOPERATIVE ANALGESIA IN PATIENTS UNDERGOING LOWER SEGMENT CAESAREAN SECTION

Main Article Content

Dr. Reshma B.M
Dr. Sahana S
Dr. Ravindra S Padial
Dr. Harsoor S S
Dr. Vinod B. N

Keywords

Dexamethasone, lower segment caesarian section, postoperative analgesia;, ropivacaine, TAP block, ultrasound

Abstract

BACKGROUND AND AIM: LSCS is the most commonly performed surgery all over the world. [1] Multimodal analgesia in the form of parenteral NSAIDs, patient-controlled analgesia with opioids, epidural analgesia, wound infiltration and peripheral nerve blocks have been tried over several decades. [2] More recently, ultrasound-guided TAP block has been described with promises of better localization and deposition of the local anaesthetic with improved accuracy. Thus, in the current study, we assess the efficacy of 0.2% ropivacaine with or without dexamethasone used as an adjuvant in USG-guided TAP block in providing postoperative analgesia in LSCS patients.


METHOD: A prospective, randomised, double-blinded study was conducted in our tertiary care hospital on sixty pregnant patients of ASA-2 posted for LSCS under spinal anaesthesia. The study population was divided into 2 groups of 30 patients each. They received a USG-guided TAP block; Group A with 20 ml of 0.2% ropivacaine alone and Group B with 20 ml of 0.2% ropivacaine with dexamethasone 4mg on each side at the end of the surgery. Tramadol 100 mg was administered intravenously in case of NRS > 3 and the time to first rescue analgesia was noted. Patient satisfaction scores and complications like intravascular injection, local anaesthesia systemic toxicity, haematoma at the injection site, paresthesia, nausea, vomiting, hypotension and bradycardia were also recorded if any.


RESULTS: The time to first rescue analgesia in group A was 15.21 5.26hrs and in group B was 22.82 4.75hrs which was statistically significant. No block-related complications were noted.


CONCLUSION: We conclude that the addition of dexamethasone to ropivacaine in the TAP block for LSCS significantly prolongs the duration of postoperative analgesia.

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