EFFECTS OF DEXAMETHASONE AS AN ADJUVANT TO ROPIVACAINE ON DURATION AND QUALITY OF POST-OPERATIVE ANALGESIA IN ULTRASOUND-GUIDED TRANSVERSUS ABDOMINIS PLANE BLOCK IN PATIENTS UNDERGOING LOWER-SEGMENT CESAREAN SECTION

MANGILAL DEGANWA; ASTHA AGARWAL; VIGYA GOYAL; VIJETA JAIN; DURGA JETHAVA

doi:10.22159/ajpcr.2023.v16i4.47272

Authors

MANGILAL DEGANWA Department of Anesthesiology, Mahatma Gandhi Hospital, Jaipur, Rajasthan, India.
ASTHA AGARWAL Department of Anesthesiology, Mahatma Gandhi Hospital, Jaipur, Rajasthan, India.
VIGYA GOYAL Department of Anesthesiology, Mahatma Gandhi Hospital, Jaipur, Rajasthan, India.
VIJETA JAIN Department of Anesthesiology, Mahatma Gandhi Hospital, Jaipur, Rajasthan, India.
DURGA JETHAVA Department of Anesthesiology, Mahatma Gandhi Hospital, Jaipur, Rajasthan, India.

DOI:

https://doi.org/10.22159/ajpcr.2023.v16i4.47272

Keywords:

Dexamethasone, Lower-segment caesarean section, Ropivacaine

Abstract

Objective: The aim of this study was to measure the effect of adding dexamethasone to ropivacaine on the duration and quality of post-operative analgesia in patients undergoing lower-segment caesarean section (LSCS) who are receiving ultrasound-guided transverse abdominal plane (TAP) blocks.

Methods: An interventional, prospective, randomized, and double-blind trial was conducted at a hospital. Before beginning the investigation, the Institutional Ethics Committee permission was acquired. The patient characteristics were analyzed using the Students t-test for continuous variables and the Chi-square test for categorical variables. A total of 60 patients were randomly split into two groups of 30 each.

Results: Time to first rescue analgesia was significantly shorter in Group R (11.62±3.80 h) than the Group D (19.04±4.20 h) (p<0.001). The total tramadol requirement in post-operative period was significantly higher in Group R (86.67±30.55 mg) than the Group D (35.56±39.54 mg) (p<0.001).

Conclusion: The use of dexamethasone along with 0.1% ropivacaine prolongs the analgesic duration of TAP block in patients undergoing LSCS.

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Author Biographies

MANGILAL DEGANWA, Department of Anesthesiology, Mahatma Gandhi Hospital, Jaipur, Rajasthan, India.

Associate professor, Department of Anesthesiology

ASTHA AGARWAL, Department of Anesthesiology, Mahatma Gandhi Hospital, Jaipur, Rajasthan, India.

Senior resident, Department of Anesthesiology

VIGYA GOYAL, Department of Anesthesiology, Mahatma Gandhi Hospital, Jaipur, Rajasthan, India.

Assistant Professor, Department of Anesthesiology

VIJETA JAIN, Department of Anesthesiology, Mahatma Gandhi Hospital, Jaipur, Rajasthan, India.

Resident, Department of Anesthesiology

DURGA JETHAVA, Department of Anesthesiology, Mahatma Gandhi Hospital, Jaipur, Rajasthan, India.

Professor, Department of Anesthesiology

References

Rafi AN. Abdominal field block: A new approach via the lumbar triangle. Anaesthesia 2001;56:1024-6. doi: 10.1046/j.1365-2044.2001.02279- 40.x, PMID 11576144

McDonnell JG, Curley G, Carney J, Benton A, Costello J, Maharaj CH, et al. The analgesic efficacy of transversus abdominis plane block after cesarean delivery: A randomized controlled trial. Anesth Analg 2008;106:186-91.

Shrestha BR, Maharjan SK, Tabedar S. Supraclavicular brachial plexus block with and without dexamethasone - a comparative study. Kathmandu Univ Med J (KUMJ) 2003;1:158-60.

Akkaya A, Yildiz I, Tekelioglu UY, Demirhan A, Bayir H, Ozlu T, et al. Dexamethasone added to levobupivacaine in ultrasound-guided tranversus abdominis plain block increased the duration of postoperative analgesia after caesarean section: A randomized, double blind, controlled trial. Eur Rev Med Pharmacol Sci 2014;18:717-22. PMID 24668714

Cummings KC 3rd, Napierkowski DE, Parra-Sanchez I, Kurz A, Dalton JE, Brems JJ, et al. Effect of dexamethasone on the duration of interscalene nerve blocks with ropivacaine or bupivacaine. Br J Anaesth 2011;107:446-53. doi: 10.1093/bja/aer159, PMID 21676892

Jensen MP, Chen C, Brugger AM. Interpretation of visual analog scale ratings and change scores: A reanalysis of two clinical trials of postoperative pain. J Pain 2003;4:407-14. doi: 10.1016/s1526- 5900(03)00716-8, PMID 14622683

De Oliveira GS Jr., Alves LJ, Nader A, Kendall MC, Rahangdale R, McCarthy RJ. Perineural dexamethasone to improve postoperative analgesia with peripheral nerve blocks: A meta-analysis of randomized controlled trials. Pain Res Treat 2014;2014:179029.

Abdalla W. Ultrasound-guided transversus abdominis plane block for radical cystectomy with and without dexamethasone: A prospective, double-blinded controlled trial. Ain Shams J Anaesthesiol 2014;7:539-44. doi: 10.4103/1687-7934.145709

Chu CC, Hsing CH, Shieh JP, Chien CC, Ho CM, Wang JJ. The cellular mechanisms of the antiemetic action of dexamethasone and related glucocorticoids against vomiting. Eur J Pharmacol 2014;722:48-54. doi: 10.1016/j.ejphar.2013.10.008, PMID 24184695

Huynh TM, Marret E, Bonnet F. Combination of dexamethasone and local anaesthetic solution in peripheral nerve blocks: A meta-analysis of randomised controlled trials. Eur J Anaesthesiol 2015;32:751-8. doi: 10.1097/EJA.0000000000000248, PMID 25774458

Choi S, Rodseth R, McCartney CJ. Effects of dexamethasone as a local anaesthetic adjuvant for brachial plexus block: A systematic review and meta-analysis of randomized trials. Br J Anaesth 2014;112:427-39. doi: 10.1093/bja/aet417, PMID 24413428