Comparative Study between the Effects of Dexamethasone versus Dexmedetomidine as Additives to Transversus Abdominal Block on Post-Operative Analgesia in Elective Caesarean Sections

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Abstract Background The transversus abdominis plane (TAP) block is a peripheral nerve block designed to anesthetize the nerves supplying the anterior abdominal wall (T6 to L1). It was first described in 2001 by Rafi as a traditional blind landmark technique using the lumbar triangle of Petit. Dexamethasone acts locally on nociceptive C-fibers (through glucocorticoid receptors) to increase the activity of inhibitory potassium channels, thus decreasing their activity. The combined use of a local anesthetic agent and dexmedetomidine, applied in a TAP block, which targets peripheral nociceptive receptors, may be an ideal protocol for pain control after abdominal surgery. Aim and Objectives The main and primary goal of this research is to compare the efficacy and safety of dexmedetomidine and dexamethasone as a local anesthetic adjuvant to bupivacaine in TAP block for patients scheduled for elective CS. The secondary goal is to assess the effect of both additives as regard the duration of block. Subjects and Methods This was a Double blinded 2-arms parallel controlled trial, which was conducted in Ain Shams University Hospitals for 6 months, it was carried out on 50 full term pregnant women. Result Data showed no statistically significant difference according to demographic data, medical history, laboratory investigation (Mean±SD), heart rate, mean arterial blood pressure mmHg, mean random blood sugar, VAS score, time to need analgesics, and Side effects between groups. Conclusion the current study showed that both dexmedetomidine and dexamethasone were equally safe and effective as a local anesthetic adjuvant to bupivacaine in TAP block for patients scheduled for elective CS.

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