Comparison of the efficacy of bupivacaine versus bupivacaine plus dexamethasone during surgical TAP block for post operative analgesia after caesarean section

Introduction and Aim: 1: Dexamethasone is steroid which can be used as add on to local anesthetic for prolonging the duration of action and has been studied in different neuroaxial blocks. We undertake this study by comparing the efficacy of bupivacaine alone versus bupivacaine plus dexamethasone during the surgical TAP block during caesarean section; 2: To correlate the advantages, disadvantages and adverse effects of the drugs during the surgical TAP block. Methods and Materials: A double blind randomized control study to include 100 women was approved by the institutional ethics committee. Patients were randomized as Group A: received surgical TAP block with Bupivacaine alone. Group B: received TAP block with Bupivacaine plus dexamethasone. Dose of the drug was adjusted with respect to the weight of the patient and surgical TAP block was administered via trans-peritoneal route. Visual analogue score (VAS) was assessed by a blinded observer. Time required for rescue analgesia in minutes was measured. The ’Mann-Whitney U test’ was used for statistical analysis. Results: The duration of post operative analgesi a was prolonged in group B. Group A Bupivacaine had post op duration of analgesia (mean SD 268.80125.53 minutes), Group B Bupivacaine plus dexamethasone had post op duration of analgesia (mean SD 466.8207.86). There were no reported complications during the surgical technique or any adverse effects to bupivacaine and dexamethasone administered for the TAP block. Conclusion: Surgical TAP block with bupivacaine plus dexamethasone is more effective than with bupivacaine alone. Keywords: Transversus abdominis plane block, Bupivacaine, Dexamethasone, Surgical TAP block, Caesarean delivery.