Ultrasound-guided (USG) transversus abdominis plane (TAP) block with bupivacaine and dexmedetomidine on the control in postoperative analgesia of inguinal hernia surgery: A randomized clinical trial

Abstract

Introduction: Transversus abdominis plane block (TAPB) is now a well-established technique in postoperative analgesia for lower abdominal surgeries. We aimed to investigate the effects of adding dexmedetomidine to bupivacaine used in USG (TAP block on postoperative pain and complications in patients undergoing inguinal hernia repair.

Materials and Methods: About 66 eligible patients enrolled in the survey. They were randomly assigned to one of the two groups of 20 CC of bupivacaine 0.5% + 1 CC Normal saline or 20 CC of bupivacaine 0.5% + 100µg dexmedetomidine. The amount of pethidine consumption, postoperative VAS score, and complications were measured. Patients were evaluated at the recovery ward (T0) and 2, 4, 6, 12, and 24 hours after surgery. Regarding the VAS score and if the patient's pain complained from a VAS≥3, pethidine 0.5 mg/kg was administered. The total dose, the average dose of pethidine used, and the first time of pethidine administration after the nerve block was recorded.

Results: Two groups had no significant difference regarding baseline characteristics. A significant difference was found at T4 about VAS (P=0.005). The amount of pethidine consumption was lower in the DEX group but not statistically significant except for T4 (P=0.006). The two groups showed no difference regarding side effects such as PONV.

Concussion: Injection of dexmedetomidine in combination with bupivacaine for TAPB is an effective and safe drug for controlling pain after hernia surgery.