Efficacy of Dexmedetomidine as an Adjuvant to Bupivacaine in Ultrasound-Guided Transverse Abdominis plane Block for Laparoscopic appendicectomy: A Randomised Controlled Study

Objective: Dexmedetomidine is an alpha 2-adrenergic agonist that prolongs analgesia as an adjuvant when added in neuraxial and peripheral nerve blocks. The aim of the present study was to evaluate the efficacy of dexmedetomidine as an adjuvant to bupivacaine in ultrasound (US-G)-guided transverse abdominis plane (TAP) block for postoperative analgesia in laparoscopic appendicectomy. Methods: A total of 60 American Society of Anesthesiologists I and II adult patients aged between 16 and 60 years planned for laparoscopic appendicectomy were randomised into two groups (A and B). Group A patients received 20 mL of 0.125% bupivacaine+1 mu g kg(-1) dexmedetomidine, whereas group B patients received 20 mL of 0.125% bupivacaine alone on both sides at the time of USG-guided TAP block. Haemodynamic variables, pain scores, sedation scores, time to first dose of rescue analgesic and side effects, if any, were assessed and compared between the groups. Results: Demographic and operative characteristics were comparable in both groups. The mean duration of analgesia was more in group A (7.33 h) than in group B (4.8 h). The requirement of rescue analgesics was more in group B (80%) than in group A (56.7%). The sedation and pain scores at 2, 4 and 6 h were better in group A than in group B (p<0.05). The heart rate, systolic blood pressure and diastolic blood pressure were lower in group A during the postoperative period than in group B. Conclusion: The addition of dexmedetomidine as an adjuvant to bupivacaine in TAP block provides prolonged postoperative analgesia and better pain control with reduced need for rescue analgesics than bupivacaine alone in patients undergoing laparoscopic appendicectomy.