Efficacy of perineural versus systemic dexamethasone to prolong analgesia after ultrasound guided TAP block for patients undergoing lower abdominal surgeries

Abstract

Poorly controlled acute pain after surgery is associated with a variety of unwanted postoperative consequences, including patient suffering, distress, myocardial ischemia, prolonged hospital stay and increase of chronic pain. Neuroaxial block is used for postoperative pain management and decrease analgesic use. Many adjuvant drugs are added to bupivacaine to prolong the duration of sensory block like opioids and dexamethasone. Clinically, Dexamethasone is a synthetic glucocorticoid with anti-inflammatory & immunosuppressant properties which has a rapid onset & long duration of action. Adverse effects are extremely rare and not reported for perineural injection however, minimal adverse effects were reported for systemic injection. The aim of this thesis was to study the effect of adding dexamethasone to both perineural & systemic as an adjuvant to bupivacaine in TAP block. The comparison included the effect on postoperative pain, postoperative analgesic requirement and haemodynamics. In our study, 52 patients were randomly divided into two equal groups: