Comparative Study between Levobupivacine versus Levobupivacaine Plus Dexmedetomidine for Transversus Abdominis Plane Block ?TAP? in Post-Operative Pain Management after Abdominoplasty
Journal Title: Enliven: Journal of Anesthesiology and Critical Care Medicine - Year 2015, Vol 2, Issue 2
Abstract
Aim of the work Transversus abdominis plane “TAP’’ block has been reported to be effective for post-operative analgesia for patients undergoing surgery involving abdominal wall incision by blocking anterior branches of thoracolumbar nerves originating from T6 – L1 , which innervates anterior abdominal wall. Dexmedetomidine has a well – known benefit in the relief of postoperative pain. The objective of this study is to evaluate effect of adding dexmedetomidine to levobupivacaine for preemptive TAP block in the post-operative pain management after abdominoplasty surgery. Methods Sixty nine ASA I and II patients undergoing cosmetic abdominoplasty surgery under general anesthesia were randomly assigned in a double – blinded study divided into 3 groups. One group received bilateral TAP block performed by landmark – based technique with 20 ml 0.375% levobupivacaine plus 1 ml normal saline on each side “L group ‘’ and second dexmedetomidine group “M group ‘’received same volume of levobupivacaine plus 100µg dexmedetomidinein 1 ml, third control group” C group “received 21 ml normal saline on each side all patients received the block after induction of anesthesia and before surgical incision. Postoperative pain scores were recorded based on a visual analogue scale “VAS” using a 10 cm ruler where 0= no pain and 10 =worst possible pain just after full recovery and before administration of analgesics. Patients received meperidine 1mg/kg for every 4 h either on demand or if pain score ≥ 3. Total dose of mepridine consumption was recorded. Level of sedation, and side effects were also recorded. Results 23 patients of each group complete the study. Patients in M, L groups had significant lower pain score as compared to C group. Total postoperative 24 hours meperidine consumption in M, L group were significantly less than C group p < 0.001. Total postoperative 24 hours meperidine consumption in M group was less than in L group P < 0.01. There were a higher incidence of nausea, vomiting and use of anti-emetic in C group in comparison to L, M groups. Conclusion TAP block with 0.375 % levobupivacaine plus dexmedetomidine preemptively decrease pain score and postoperative narcotic consumption in patients undergoing cosmetic abdominoplasty surgery.
Authors and Affiliations
Abdelaal Wail, Anis Metry Ayman, Refaat Mona, Ragaei Milad, Nakhla George
Keywords
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