Comparison of Efficacy of Bupivacaine with Dexmedetomidine Versus Bupivacaine Alone for Transversus Abdominis Plane Block for Post-operative Analgesia in Patients Undergoing Elective Caesarean Section

Background: Increasing rate of Caesarean sections and inadequate pain relief following Caesarean section is seen in almost all parts of the world. Transversus abdominis plane block is gaining popularity as a part of multimodal analgesia for post-operative pain relief following abdominal surgeries. Aim: To compare bupivacaine and bupivacaine with dexmedetomidine in transversus abdominis plane block for pain relief after Caesarean section. Method: American Society of Anaesthesiologists I and II parturients with no comorbidities admitted for elective Caesarean section were included in the study. Thirty-five patients were in each study (with dex) and control (without dex) groups. At the end of Caesarean section done under spinal anaesthesia, transversus abdominis plane block was done bilaterally under ultrasound guidance using in-plane technique of needle insertion. 20 ml of 0.25% bupivacaine with 0.5 mcg/kg of dexmedetomidine in the study group and 20 ml of 0.25% bupivacaine in the control group were injected in the neurovascular plane. Results: Eight patients from the study group and 15 from the control group were given opioids as rescue analgesia. The average time at which rescue analgesia was first sought was 14.25 and 7.73 h in the study and control groups, respectively. The P value of this difference was 0.0136 and was found to be statistically significant. Conclusion: The addition of dexmedetomidine to bupivacaine in TAP block prolonged the duration of time at which first dose of rescue analgesia was sought and also reduced the total dose of opioid requirement in the first 24-h post-Caesarean section. © 2017, Federation of Obstetric & Gynecological Societies of India.