Comparative Study between Bupivacaine versus Bupivacaine with Dexmedetomidine in Ultrasound Guided Transversus Abdominis Plane Block as Postoperative Analgesia in Open Inguinal Hernia

Abstract Background A recent myofascial plane block, the transversus abdominal plane block (TAP), has been shown to lessen not only postoperative discomfort after surgery of inguinal hernia but also hospital stay. It is our objective to achieve postoperative satisfaction regarding the pain with the least side effects as related with opioids. Methods The study was registered at Pan African-Clinical Trial Registry.org with ID of (PACTR 202301487176282), randomized clinical trial, after obtaining approval from the Research Ethical Committee of Ain Shams University, this study was done in the general surgery theatres of Ain Shams University Hospitals for 12 months. Results In this study, TAP block with dexmedetomidine was more effective than TAP alone as measured by visual analog scale (VAS) scores, regarding first analgesic request and change in vital data. Significant differences in VAS scores were observed at 6 hours up to 24 hours postoperatively (p < 0.01), but not during the first 6 hours. Heart rate was obviously diminished in the Bupivacaine with Dexmedetomidine (BD) group compared to the Bupivacaine (B) group starting at 2 hours postoperatively, while mean blood pressure was eased from 6 hours up to 24 hours postoperatively. Total analgesic consumption and time to first analgesic request were decreased in the BD group, while the incidence of nausea and vomiting were similar between the two groups. Conclusions The addition of dexmedetomidine to bupivacaine in TAP block extends the duration of time at which first dose of rescue analgesia and also reduced the total dose of opioid requirement in the first 24-h postoperatively.