Analgesic Efficacy Of Dexmedetomidine As An Adjuvant To Ropivacaine In Ultrasound-Guided Transversus Abdominis Plane Block In Inguinal Hernia Surgery: A Randomised Controlled Study

Abstract

Introduction: Postoperative pain following abdominal surgery significantly affects patient recovery and satisfaction. The Transversus Abdominis Plane (TAP) block has emerged as a regional anaesthesia technique targeting the nerves of the anterior abdominal wall. While ropivacaine offers prolonged analgesia with minimal motor blockade, its efficacy may be limited for extended relief. Adjuvants like dexmedetomidine have been introduced to enhance analgesic effects.

Objective: To assess the efficacy of dexmedetomidine as an adjuvant to ropivacaine in TAP blocks for postoperative analgesia, comparing analgesic duration, quality, patient satisfaction, and safety profiles.

Methods: This comprehensive literature-supported report evaluates multiple clinical trials involving TAP blocks administered with ropivacaine alone versus in combination with dexmedetomidine. Both landmark-based and ultrasound-guided TAP block techniques are described. Evaluated parameters include pain scores, time to rescue analgesia, adverse effects, sedation, and overall patient recovery.

Results: The two groups were comparable in age, ASA status, and weight (all p>0.4). Adverse drug reactions were significantly fewer in Group RD (26.7%) than RN (46.7%, p<0.001). Group RD demonstrated a longer duration of analgesia (19.47 ± 4.03 vs 10.73 ± 0.43 h, p<0.001), lower rescue analgesic requirement (129.50 ± 9.22 vs 158.90 ± 15.09 mg, p=0.001), and consistently lower VAS pain scores (p=0.000). Hemodynamic parameters remained stable and comparable. Patient satisfaction was significantly higher in RD (4.60 ± 0.50 vs 3.77 ± 0.77, p=0.000).

Conclusion: The combination of dexmedetomidine with ropivacaine in TAP blocks provides superior postoperative analgesia compared to ropivacaine alone. It is a safe and effective strategy, particularly for abdominal surgeries, offering a promising enhancement to multimodal analgesia protocols.