Comparative Study Between Bupivacaine 0.5% Versus Bupivacaine 0.5% with Fentanyl in TAP Block for Post-Operative Analgesia After Appendectomy

Abstract

ost operative pain and stress is a very known complication of many surgical procedures which represents a burden for the patient and associated with many complications including stress, myocardial ischemia, prolonged hospital stay and the need of extensive post operative analgesia. Regional anesthesia techniques like TAP block are a well suited techniques for minimizing the incidence of post operative pain, reducing the need of high dosage intra operative and post operative analgesia, although local anesthetics alone can achieve satisfactory response, it had been found that addition of many adjuvant as clonidine, ketamine, opiods like Fentanyl, magnesium, dexmedetomidine and dexamethazone can improve the onset and the duration of the sensory and the motor block provided by regional anesthesia. The introduction of ultrasound technique in regional anesthesia like TAP block provided both increased successful dense block to neural structures, also minimizing the incidence of complications or failure of the block. Fentanyl is similar to other opioid drugs, it target opioid receptors being selective on MU receptors, (mu selective agonist) but it also can act on other opioid receptors like kappa and delta. This interaction with the opioid receptors especially the Mu receptors produce its analgesic effect with subsequent