Assessment of the Impact of Two Dexmedetomidine Dosages Added with Bupivacaine in Ultrasound-Guided Transversus Abdominis Plane Block for Postoperative Analgesia Following Inguinal Hernia Repair: A Randomized Double-Blind Study

Abstract

Background: Open surgery for inguinal hernia is a frequently executed technique that may result in significant postoperative pain. The transversus abdominis plane (TAP) block is extensively employed as a component of a multimodal analgesic strategy to manage this discomfort. This study aimed to assess the effectiveness of two dosages of dexmedetomidine (0.5 µg/kg and 1 µg/kg) combined with isobaric bupivacaine in transversus abdominis plane blocks for analgesia after unilateral inguinal hernia surgery.Methods: One hundred individuals slated for elective spinal anesthesia-based unilateral inguinal hernia surgeries participated in this study. Two groups of fifty participants each were randomly assigned. Group D1 was given a TAP block that included 0.5µg/kg of dexmedetomidine and bupivacaine, while Group D2 had the same block but with an increased dosage of 1µg/kg of dexmedetomidine.Results: The results indicated a substantial decrease in Visual Analogue Scale (VAS) pain scores for Group D2 relative to Group D1, both at rest and during movement, at the 6- and 12-hour intervals. Moreover, patients in Group D2 necessitated reduced postoperative analgesics, encompassing both paracetamol and ketorolac, and exhibited an extended duration prior to requiring the initial dosage of analgesics in comparison to Group D1.Conclusion: The combination therapy of 1 µg/kg dexmedetomidine with bupivacaine demonstrated enhanced analgesic efficacy relative to 0.5 µg/kg, evidenced by prolonged TAP block duration, diminished postoperative VAS scores during both movement and rest, and decreased analgesic requirements. The advantages were observed without any adverse effects, save from an increased incidence of bradycardia in the 1 µg/kg group.