EFFECT OF ADDING DEXMEDETOMIDINE AS AN ADJUVANT TO ROPIVACAINE ON ANALGESIC EFFICACY OF TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK IN PATIENTS UNDERGOING GENERAL ANESTHESIA FOR PARAUMBILICAL HERNIA REPAIR

Abstract

Background: Paraumbilical hernia repair causes significant postoperative pain, often requiring opioids. TAP block reduces pain but has limited duration. Adding dexmedetomidine to ropivacaine may prolong analgesia; although evidence exists for other surgeries, data on umbilical hernia repair are limited, so this study compared both regimens for pain control and satisfaction.

Objective: To compare analgesic outcome of transversus abdominis plane block using dexmedetomidine as adjuvant to ropivacaine vs. ropivacaine alone in patients undergoing general anesthesia for paraumbilical hernia repair. 

Methods: After ethical approval, 60 elective paraumbilical hernia patients were randomized into two groups. Group R received bilateral TAP block with ropivacaine 0.3% (20 ml each side), while Group RD received ropivacaine 0.3% plus dexmedetomidine 0.5 µg/kg. Pain, rescue analgesia, and satisfaction were assessed for 24 hours, with all procedures performed by a single anesthesiologist and analyzed using SPSS v17.

Results: Sixty patients were included with comparable demographics (p>0.05). Postoperative pain scores were significantly lower in Group RD at 1, 6, 12, and 24 hours (p=0.001, 0.005, 0.014, 0.001). Time to rescue analgesia was longer in Group RD (16.67±7.21 vs 8.06±6.27 hours; p=0.004), with higher patient satisfaction (96.7% vs 73.3%; p=0.026).    

Conclusion: The addition of dexmedetomidine to ropivacaine for transversus abdominis plane block significantly improved postoperative analgesia in patients undergoing paraumbilical hernia repair. It resulted in lower pain scores, prolonged duration of analgesia, reduced need for rescue analgesics, and higher patient satisfaction, without adverse effects.