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Transverse abdominis plane (TAP) block is a regional anaesthesia technique that provides analgesia to the parietal peritoneum as well as skin and muscles of the anterior abdominal wall. In the past, a number of adjuvants have been added to the local anaesthetics in peripheral and neuraxial blocks resulting in an effective and long lasting analgesia.In recent times, dexamethasone has been increasingly used as an adjuvant to local anaesthetics in peripheral nerve blocks. Dexamethasone has a long and efficient glucocorticoid structure and also has anti-inflammatory property. It also blocks the C- fibers of pain pathway. When added to local anaesthetics as an adjuvant in peripheral nerve blocks, it has shown to prolong the analgesia time. A number of previous studies have also shown an opioid sparing effect of steroids, when used intravenously perioperatively. Though previous studies have shown that addition of dexamethasone to local anaesthetics in transverse abdominis plane block prolongs the duration of block, however it is not known whether this effect of dexamethasone is due to its peripheral action or because of its systemic absorption. Thus, in this study planned to compare the effectiveness of dexamethasone on quality and duration of analgesia when used as an adjuvant with local anaesthetics in transverse abdominis plane block versus when given systemically by intravenous route along with transverse abdominis plane block using local anaesthetics only, in patients undergoing gynaecological laparoscopic procedures under general anaesthesia.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Perineural group | Experimental | Group 1: perineural dexamethasone acetate added to bilateral transverse abdominis plane block with levobupivacaine |
|
| Intravenous group | Active Comparator | Group 2: Intravenous dexamethasone acetate added with bilateral transverse abdominal plane block with levobupivacaine |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Perineural Dexamethasone acetate | Drug |
|
| |
| Intravenous dexamethasone acetate |
| Measure | Description | Time Frame |
|---|---|---|
| Time to first rescue analgesic | Pain will be assessed by vas score, if vas score more than 3 rescue analgesia will be given. Duration between the end of anaesthesia to first analgesic requirement during first 24 hours of postoperative period. | first 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Total amount of rescue analgesic required in 1st 24 hours postoperatively | Pain will be assessed by vas score, if vas score more than 3 rescue analgesia will be given. | 0, 0.25, 0.50, 0.75, 1 , 2, 4, 6, 8,12, 24 hours |
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Inclusion Criteria:
Exclusion Criteria:
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| Drug |
|
|
| ID | Term |
|---|---|
| D007246 | Infertility |
| ID | Term |
|---|---|
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
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