Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Jul;6(3):229-33.
doi: 10.4103/1658-354X.101213.

Effect of adding dexamethasone to bupivacaine on transversus abdominis plane block for abdominal hysterectomy: A prospective randomized controlled trial

Amany S Ammar  1 , Khaled M Mahmoud
Affiliations

Effect of adding dexamethasone to bupivacaine on transversus abdominis plane block for abdominal hysterectomy: A prospective randomized controlled trial

Amany S Ammar et al. Saudi J Anaesth. 2012 Jul.

Abstract

Purpose: Different adjuvants have been used to improve the quality and increase the duration of local anesthetics during various nerve block techniques. The current study was aimed to evaluate the effect of adding dexamethasone to bupivacaine on the quality and duration of transversus abdominis plane (TAP) block.

Methods: Sixty adult patients undergoing elective open abdominal hysterectomy were randomly allocated to receive TAP block using 20 mL of bupivacaine hydrochloride 0.25% + 2 mL saline 0.9% (control group, n=30) or 20 mL of bupivacaine hydrochloride 0.25% + 2 mL dexamethasone "8 mg" (dexamethasone group, n=30). The primary outcome was postoperative pain, as evaluated by visual analog scale (VAS) for pain scoring at 1, 2, 4, 12, 24 and 48 h postoperatively, whereas the secondary outcomes were time to first analgesia (TFA), morphine consumption and the occurrence of nausea, vomiting or somnolence.

Results: The pain VAS score was significantly lower at the postoperative 2 h (4.9 vs. 28.1, P=0.01), 4 h (12.2 vs. 31.1, P=0.01) and 12 h (15.7 vs. 25.4, P=0.02). Furthermore, TFA was significantly longer in the dexamethasone group (459.8 vs. 325.4 min, P=0.002), with lesser morphine requirements in the postoperative 48 h (4.9 vs. 21.2 mg, P=0.003) and lower incidence of nausea and vomiting (6 vs. 14, P=0.03). No complications attributed to the block were recorded.

Conclusion: Addition of dexamethasone to bupivacaine in TAP block prolonged the duration of the block and decreased the incidence of nausea and vomiting.

Keywords: Bupivacaine; dexamethasone; transversus abdominis plane block.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None declared.

References

    1. Wall PD, Melzack R. Pain measurements in persons in pain. In: Wall PD, Melzack R, editors. Textbook of pain. 4th ed. Edinburgh, UK: Churchill Livingstone; 1999. pp. 409–26.
    1. Tran TMN, Rozen W, Ashton M, Barrington M, Ivanusic J, Taylor G. Redefining the course of the intercostal nerves: A new understanding of the innervation of the anterior abdominal wall. Clin Anat. 2008;21:325–33. - PubMed
    1. Rafi A. Abdominal field block: A new approach via the lumbar triangle. Anaesthesia. 2001;56:1024–6. - PubMed
    1. Netter FH. Abdomen posterolateral abdominal wall. In: Netter FH, editor. Atlas of human anatomy summit. New Jersey, USA: The Ciba-Geigy Corporation; 1989. pp. 230–40.
    1. Kapral S, Goolann G, Walt B, Likar R, Sladen RN, Weinstabl C, et al. Tramadol added to mepivacaine prolongs the duration of an axillary brachial plexus blockade. Anesth Analg. 1999;88:853–6. - PubMed