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Subject Area

Anesthesiology and Intensive Care

Article Type

Original Study

Abstract

Background Ultrasound subcostal transversus abdominis plane block is an efficacious field block in abdominal surgeries. Various adjuvants have been used to prolong the local anesthetic effect. Objectives To evaluate the effect of adding dexamethasone to bupivacaine on pethidine consumption in the first 24 h postoperatively as a primary objective. Patients and methods Our randomized controlled double-blinded trial was conducted on 44 patients with American Society of Anesthesiologists physical status I and II, aged more than or equal to 18 and less than or equal to 60 years, scheduled for upper abdominal surgery under general anesthesia. The study was conducted at the National Liver Institute and Menoufia University Hospitals. Patients were randomly divided into two groups, with 22 patients each. Patients in group LD received 20 ml of 0.25% bupivacaine and 2 ml of dexamethasone (8 mg). Group L received 20 ml of 0.25% bupivacaine. Results Pethidine consumption in 24 h was higher among the L group than the LD group. Its mean in the LD group was 119.44 ± 62.16 and was 160 ± 55.25 in the L group; this difference was statistically significant. The first time of analgesia was significantly longer among the LD than the L group (3.62 ± 1.63 in group LD and 2.43 ± 1.25 in group L); the difference was statistically significant. Visual analog scale score was significantly higher in the L group at 1 h than in the LD group. Median (interquartile range) was 2 (2–3) in the LD group and was 3 (2–3) in the L group; this difference was statistically significant. Conclusion The results showed that dexamethasone is a good additive to subcostal transversus abdominis plane block as it prolongs the duration of analgesia and reduces postoperative pain scores after upper abdominal surgeries.

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