A COMPARATIVE STUDY OF ROPIVACAINE AND ROPIVACAINE WITH DEXMEDETOMIDINE IN TRANSVERSUS ABDOMINIS PLANE BLOCK FOR POST-OPERATIVE ANALGESIA AND EARLY MOBILIZATION IN PATIENTS UNDERGOING ELECTIVE INGUINAL HERNIORRHAPHY

Abstract

Objectives: This study aimed to compare the efficacy of ropivacaine alone and ropivacaine with dexmedetomidine, which is used for transversus abdominis plane block (TAP) in patients undergoing inguinal hernia repair. The primary outcome was the time to first request for rescue analgesia (defined as Visual Analog Scale [VAS] ≥4). Secondary outcomes included VAS scores at specified time points, total tramadol consumption at 24 h, and incidence of adverse events. Methods: A total of 66 patients who underwent elective herniorrhaphy and met the inclusion and exclusion criteria from January 2022 to December 2022 were included in the study. In both groups, surgery was done under spinal analgesia using 3ml of 0.5% bupivacaine heavy. Ultrasonography-guided TAP was performed at the end of the procedure. The Group R received a TAP block with 18 mL of 0.2% ropivacaine+2 mL of normal saline, and Group RD received a TAP block with 18 mL of 0.2% ropivacaine combined with 1.0 μg/kg dexmedetomidine in 2 mL of normal saline. Results: When comparing ropivacaine alone, the mean time to the first reporting of substantial post-operative pain VAS ≥4) was longer. The mean time to first rescue analgesia was significantly higher in the RD group (12.576±2.17 h) when compared with Group R (6.636±1.32 h; p<0.001). VAS scores at 4 h, 6 h, and 12 h are statistically significant (p<0.0001). This shows that the VAS pain score at 4 h, 6 h, and 12 h is better in Group RD than in Group R. We find that the tramadol dose received by Group R at 24 h is 136.36 mg, whereas the dose received by Group RD is 62.12 mg (p<0.001). Conclusion: When compared to conventional ropivacaine, adding adjunct dexmedetomidine in TAP block prolonged the analgesic duration without consequences in hemodynamic parameters.