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Research Article | Volume 13 Issue:3 (, 2023) | Pages 2288 - 2298
A Comparative Study of Fentanyl Vs Dexmedetomidine as an Adjuvant to Ropivacine in Transversus Abdominis Plane Block for Patients Undergoing Lower Abdominal Surgeries
1
Associate Professor, Department of Anaesthesiology, Government Mohan Kumaramangalam Medical College, Salem, India.
Under a Creative Commons license
Open Access
DOI : 10.5083/ejcm
Received
Aug. 2, 2023
Revised
Aug. 22, 2023
Accepted
Sept. 5, 2023
Published
Sept. 30, 2023
Abstract

Background:  Transversus Abdominis plane (TAP) block has been effectively used for anterior abdominal wall analgesia. The aim of the study was to compare the duration of analgesia produced by two drugs fentanyl and dexmedetomidine as adjuvants to Ropivacaine in TAP block under ultrasound‑guidance after lower abdominal surgeries in a randomized controlled trial. Material and Methods: Fifty patients of American Society of Anaesthesiologists (ASA) physical status I & II assessed for lower abdominal surgeries were randomized to receive TAP blocks on each side of the abdomen using the local anesthetic drug 20 ml of 0.5% Ropivacaine with either fentanyl 25 mcg or dexmedetomidine 25 mcg. A ten point numerical pain score was done at baseline, at 1 h and then at intervals of 4 h postoperatively. The hemodynamic parameters such as heart rate, blood pressure, and pulse oximetry were also monitored as above. The time to first analgesia demand from the time of the block and the total duration of analgesia were recorded. The statistical analysis was done by Mann‑Whitney U test. Results: Our primary end‑point was to assess the duration of analgesia produced by fentanyl added to Ropivacaine for ultrasound‑guided TAP block, which were 368 min with and dexmedetomidine 428 min with (P value = 0.001). The time for first rescue analgesics used in the postoperative period in both the groups were analysed using the paired T- test and found to have significant difference between both the groups (P‑value <0.05). Conclusion: This study demonstrated that the addition of dexmedetomidine as an adjunct to Ropivacaine for TAP block is marginally superior to fentanyl in terms of providing postoperative analgesia which in turn patient recovery. Dexmedetomidine provides superior analgesia yet uses less analgesic medication.

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