Intraoperative and Postoperative Effects of Dexmedetomidine as an Adjuvant to Bupivacaine in Transversus Abdominis Plane Block in Lower abdominal Surgeries

Background: Lower abdominal surgeries often result in severe pain, which in turn can affect the pattern of breathing and cause discomfort, irritation, and poor patient compliance. This investigation aimed to compare the analgesic efficacy of adding dexmedetomidine (DEX) as an adjuvant to bupivacaine in TAP block intraoperatively and postoperatively in lower abdominal surgeries. Methods: This prospective investigation included 60 cases undergoing lower abdominal surgery, randomly assigned into two equal groups. Group B received 40 mL of 0.25% bupivacaine (20 mL per side), while Group BD received 20 mL of 0.5% bupivacaine mixed with 0.5 mcg/kg DEX and diluted to 40 mL (20 mL per side) for TAP block. Results: NRS measurements at 2h, 4h, and 6h were statistically significantly diminished in Group BD in contrast with Group B (P<0.001). Time to first rescue analgesia was statistically significantly prolonged in Group BD. AEs were statistically insignificantly different between both groups. Degree of patient satisfaction (excellent) was statistically significantly elevated in Group BD in contrast with Group B (P<0.001). Conclusion: DEX integration into TAP block protocols represents a compelling strategy to enhance postoperative pain management characterized by extended duration, reduced rescue analgesic consumption, and diminish pain scores, particularly during the critical early recovery phase.