Bupivacaine with dexmedetomidine versus bupivacaine alone for transversus abdominis plane block for postoperative analgesia in patients undergoing cesarean section: a comparative study

Background Transversus abdominis plane (TAP) block is a technique utilized to provide analgesia to the anterolateral abdominal wall. TAP blocks are frequently administered to cases undergoing a range of abdominal and pelvic procedures, including hysterectomies, laparoscopic surgeries, cesarean sections (C-sections), and appendectomies. The purpose of this study was to analyze the impact of adding dexmedetomidine to bupivacaine (in TAP block). Aim Primary goal: to compare efficacy of postoperative analgesia measured by visual analog scale score. Secondary goal: to compare the hemodynamic effect, analgesia duration, sedation score, and opioid requirements following a C-section in both groups (bupivacaine vs. bupivacaine and dexmedetomidine). Patients and methods The present study adopted a randomized, double-blind design. The study involved C-section patients undergoing TAP block based on predefined inclusion as well as exclusion criteria. Patients were divided into two groups. Group BD: patients ( n =30) received 35 ml plain bupivacaine (0.25%), with dexmedetomidine 0.5 μg/kg (on each side); group B (control group): patients ( n =30) received 25 ml plain bupivacaine (0.25%)+10 ml normal saline bilaterally. We compared sedation score, visual analog scale score, rescue analgesia requirement, hemodynamic data, and side effects in both groups. Results American Society of Anesthesiologists grades, mean age, weight, mean height, and BMI were comparable in both groups. In addition, the mean sedation score was higher (2.90±0.71) in group BD compared to group B (1.86±0.34) at 1 h. The total mean dose of rescue analgesia was more elevated in group B compared to group BD, and the difference was statistically significant ( P <0.05). Mean arterial pressure was significantly lower in group BD than in group B. However, none of the patients developed significant hypotension. Both groups exhibited similar overall adverse effects, with statistically significant differences. Conclusion The addition of dexmedetomidine to bupivacaine for TAP block reduces the requirement for rescue analgesia without causing any further adverse effects.