Dexamethasone-Enhanced TAP Block in Lapchole

Effect of Dexamethasone-Enhanced TAP Block Mixture on Postoperative Analgesia in Laparoscopic Cholecystectomy

The transversus abdominis plane (TAP) block is widely used as part of analgesia for abdominal surgeries such as laparoscopic cholecystectomy. While bupivacaine is commonly used for TAP blocks with reported success. Dexamethasone is often used as an adjuvant in prolonging duration of blocks; however, data on its efficacy in enhancing TAP blocks in laparoscopic cholecystectomy remain limited. This study aims to assess whether adding dexamethasone to bupivacaine in a TAP block improves postoperative pain control and reduces opioid consumption

Hypothesis Patients receiving a dexamethasone-enhanced TAP block will have a longer duration of analgesia, lower postoperative pain scores, and reduced opioid requirements compared to patients receiving local anesthetic alone.

Objectives

• Primary Objective:
• To evaluate the time to first postoperative analgesic request.
• Secondary Objectives:
• To assess postoperative pain using the Visual Analog Scale (VAS).
• To evaluate the incidence of postoperative nausea and vomiting (PONV).
• To compare total postoperative analgesic consumption.
• To assess the need for rescue analgesia.

Methods Study Design

• Prospective, randomized, double-blind clinical trial. Study Population
• Adult patients (age ≥18), ASA physical status I to III, planned for elective laparoscopic cholecystectomy. Interventions
• All patients will undergo standard general anesthesia.
• TAP block will be performed pre-induction bilaterally by an experienced anesthesiologist blinded to the injectate.
• Patients will be randomized into two groups:
• Group A (Control): 20 ml solution containing 0.25% bupivacaine + normal saline
• Group B (Intervention): 20 ml solution containing 0.25% bupivacaine + 4 mg dexamethasone + normal saline

All patients will receive standard postoperative care, including paracetamol and antiemetics

Inclusion Criteria:

• Adult Patients
• Laparoscopic Cholecystectomy Patients
• Patients able to consent

Exclusion Criteria:

• Patients allergic to dexamethasone
• Allergic to Marcaine
• Hemodynamically unstable