1. Effect of Adding Dexamethasone as a Ropivacaine Adjuvant in Ultrasound-Guided Transversus Abdominis Plane Block for Inguinal Hernia Repair.
- Author
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Kartalov A, Jankulovski N, Kuzmanovska B, Zdravkovska M, Shosholcheva M, Spirovska T, Petrusheva AP, Tolevska M, Srceva M, Durnev V, Jota G, Selmani R, and Sivevski A
- Subjects
- Adjuvants, Anesthesia adverse effects, Adult, Aged, Amides adverse effects, Analgesics, Opioid administration & dosage, Anesthesia, General, Anesthetics, Local adverse effects, Dexamethasone adverse effects, Double-Blind Method, Female, Hernia, Inguinal diagnosis, Humans, Male, Middle Aged, Morphine administration & dosage, Nerve Block adverse effects, Pain Measurement, Pain, Postoperative diagnosis, Pain, Postoperative etiology, Republic of North Macedonia, Ropivacaine, Time Factors, Treatment Outcome, Abdominal Muscles diagnostic imaging, Abdominal Muscles innervation, Adjuvants, Anesthesia administration & dosage, Amides administration & dosage, Anesthetics, Local administration & dosage, Dexamethasone administration & dosage, Hernia, Inguinal surgery, Herniorrhaphy adverse effects, Nerve Block methods, Pain, Postoperative prevention & control, Ultrasonography, Interventional
- Abstract
Background: The transverses abdominals plane block (TAP) is a regional anesthesia technique that provided analgesia to the parietal peritoneum, skin and muscles of the anterior abdominal wall. The aim of this randomized double-blind study was to evaluate postoperative analgesia on patients undergoing open inguinal hernia repair under general anesthesia (GA), (GA + TAP) block preformed with ropivacaine and (GA + TAP-D) block preformed with ropivacaine and 4 mg dexamethasone., Methods: 90 (ASA I-II) adult patients for unilateral open inguinal hernia repair were included in this study. In group I (n = 30) patents received only general anesthesia (GA). Patients in group II (n = 30) received GA and unilateral TAP block with 25 ml of 0.5% ropivacaine and the patients in group III (n = 30) received GA and unilateral TAP-D block with 25 ml of 0.5% ropivacaine + 4 mg Dexamethadsone. In this study we assessed the pain score - VAS at rest at 2, 4, 6, 12 and 24 hours after the operation and the total analgesic consumption of morphine over 24 hours., Results: There were statistically significant differences in the VAS scores between group I, group II and group III at all postoperative time points - 2(hr), 4(hr), 6(hr), 12(hr) and 24(hr). (p < 0.00001). The cumulative 24 hours morphine consumption after the operation was significantly lower in group III (5.53 1.21 mg) than in group II (6.16 2.41 mg) and group I (9.26 2.41 mg). This difference is statistically significant (p < 0.00001)., Conclusion: Concerning the inguinal hernia repair we found better postoperative pain scores and 24 hours reduction of the morphine consumption in group III (GA and TAP-D block) compared with group I (GA) and group II (GA + TAP block).
- Published
- 2015
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