Safety and efficacy of dexamethasone as an adjuvant to bupivacaine in bilateral transversus abdominis plane block in chi
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Ain-Shams Journal of Anesthesiology
(2020) 12:52
ORIGINAL ARTICLE
Open Access
Safety and efficacy of dexamethasone as an adjuvant to bupivacaine in bilateral transversus abdominis plane block in children undergoing major abdominal surgery Wael Abd Elmoneim Mohamed Abdelwahab, Hany Mohamed Elzahaby, Hanaa Abd Allah ElGendy, Ahmad Taha Saeed Abd Elwahab* and Rania Maher Hussien
Abstract Background: This prospective randomized controlled double-blind clinical study was conducted on 52 patients of both genders divided into two groups (26 patients each). Local anaesthetic solution of isobaric bupivacaine 0.25% (0.3 ml/kg) was prepared. Group A received bilateral transversus abdominis plane (TAP) block with bupivacaine and dexamethasone (0.3 mg/kg) while group B received bilateral TAP block with bupivacaine and volume of saline equal to the amount of dexamethasone given in group A. Patients were observed for FLACC pain scale at the time of discharge from the post-anaesthesia care unit and then every 2 h for 36 h after the operation. This study was conducted to assess the safety and efficacy of adding dexamethasone to bupivacaine on the quality of bilateral USguided transversus abdominis plane (TAP) block in children undergoing major abdominal surgery Results: Dexamethasone added to local anaesthetic in ultrasound-guided TAP block significantly decreased FLACC score at 8, 10, and 12 up to 24 h postoperatively, The time to the first requested analgesia was prolonged in the dexamethasone group (P = 0.000). The total dose of acetaminophen consumption over 36 h after surgery was also reduced (P = 0.000), but no difference was found regarding the total dose of rectal diclofenac (P = 0.068). Conclusion: Adding dexamethasone to isobaric bupivacaine TAP block reduces postoperative pain and analgesic requirements compared to isobaric bupivacaine TAP block alone in children undergoing major abdominal surgery. Keywords: Bupivacaine, Dexamethasone, FLACC, Transversus abdominal plane block
Background Abdominal surgery is considered one of the most commonly performed surgeries in paediatrics (Ford et al., 2014). General anaesthesia is the most common anaesthetic technique used in children; however, regional anaesthesia is required as an adjuvant to reduce the
* Correspondence: [email protected] Department of Anesthesiology, Intensive care and Pain Management, Faculty of Medicine, Ain-Shams University, Cairo 11591, Egypt
intraoperative and postoperative need for analgesia (De Beer & Thomas, 2003). Abdominal wall blocks including ilioinguinal/iliohypogastric nerve block, rectus sheath block, and TAP block are considered efficient regional anaesthetic techniques minimizing pain and demand for analgesics in abdominal surgeries thus reducing undesired adverse effects of opioids as sedation, respiratory depression, nausea, and vomiting (Tan et al., 2012).
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distributi
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