Study of Dexmedetomidine versus Fentanyl as Adjuvants to Bupivacaine in Ultrasound Guided Transversus Abdominis Plane Block for Postoperative Analgesia after Cesarean Delivery

Ali, Abdullah Abobakr; El-Aaser, Neveen Mahmoud; Abaza, Kamelia Ahmed; Mohamed, Abdalla Mohamed Goda

doi:10.21608/ejhm.2023.299502

Study of Dexmedetomidine versus Fentanyl as Adjuvants to Bupivacaine in Ultrasound Guided Transversus Abdominis Plane Block for Postoperative Analgesia after Cesarean Delivery

Document Type : Original Article

Authors

10.21608/ejhm.2023.299502

Abstract

Background: Dexmedetomidine's potential to increase blockade duration has piqued the interest of researchers as a local anaesthetic adjuvant in recent years. As an opioid analgesic, fentanyl is highly effective.
Objective: Improving postoperative analgesia after Cesarean delivery using dexmedetomidine or fentanyl as additives to bupivacaine for transversus abdominis plane block with ultrasonography guidance.
Patients and Methods: One hundred and twenty cases were randomly divided into two equal groups each included 60 cases. Group D received ultrasound guidedtransversus abdominis plane (TAP) block using dexmedetomidine 1 microgram/kg + 40 ml bupivacaine 0.25%, and the volume was divided equally and given bilaterally. Group F received ultrasound guided TAP block using fentanyl 1 microgram/kg + 40 ml bupivacaine 0.25%, and the volume was divided equally and given bilaterally.
Results: Group D had lower mean arterial pressure as well as heart rate than group F at 4, 8, 12, 18, and 24 hours post-operative. Group D had a significantly longer time to first analgesia compared to group F. Group D had significantly reduced total analgesic intake compared to group F over a 24-hour period. Rescue analgesics were needed by a greater percentage of patients in group F than in group D after 6, 12, and 24 hours. A statistically significant difference was seen between the two groups after 20 and 24 hours on the VAS, with group D scoring lower than group F.
Conclusion: Dexmedetomidine was more effective than fentanyl in providing postoperative analgesia with bupivacaine for transversus abdominis plane block with ultrasonography guidance following caesarean section.

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