Comparison clinical efficacy of dexmedetomidine and magnesium sulphate as an adjuvant to bupivacaine for transverse abdominis plane block in caesarian section for post operative analgesia

Background: The Transversus Abdominis Plane (TAP) Block is a method used for regional anaesthesia. It offers analgesia during lower abdominal surgery, especially when parietal wall pain is a significant source of discomfort. Through the local anaesthetic deposition between the Transversus Abdominis muscle and internal oblique muscle, it permits sensory blockage of the lower abdominal wall’s skin and muscles. In a hospital-based, prospective observational study we assessed the effectiveness of unilateral TAP Block with bupivacaine for postoperative analgesia in hernia repair.
Material and Methods: After institutional research ethics committee approval, the M.G.M Medical College and M.Y Hospital Anesthesiology Department will conduct this prospective randomised controlled study. Convenient sampling was used90 to randomly assign 30 patients from the American Society of Anesthesiologists physical status grade I–II, age 20–40, to three groups:
Group B (n=30) received TAP blocks on both sides with 18 ml 0.25% bupivacaine and 2 ml normal saline.
Group BM (n=30) patients received TAP blocks on both sides with 18 ml 0.25% bupivacaine, 1.5 ml (150 mg) mgso4, and 0.5 ml NS.
Group BD (n=30) patients received TAP blocks on both sides with 18 ml of 0.25% bupivacaine mixed with 2 ml of NS and 0.5 mcg/kg dexmedetomidine.
A 10-point VAS assessed post-operative analgesia. After securing intravenous lines, all patients received 10-5 ml/kg Inj. Ringer Lactate preloading injections. Premedication consisted of 0.2 mg glycopyrrolate intravenously and 4 mg ondansetron intravenously 30 minutes before surgery.
Results: Combination of 0.25% bupivacaine and 150mg magnesium sulfate and combination of 0.25% bupivacaine and 0.5mcg/kg dexmedetomidine provides longer duration of analgesia compared to 0.25% bupivacaine alone.
Conclusion: When utilized in patients undergoing inguinal hernioplasty, TAP Block with 0.25% bupivacaine offered powerful and longer duration of analgesia, with little any need for diclofenac. There were no side effects linked to TAP Block or the medications being tested.