Effect of Dexamethasone on Postoperative Analgesia Following the Transversus Abdominis Plane Block in Gynecological Laparotomies.

purposePostoperative pain is an acute pain that begins with surgical trauma and decreases as the tissue heals. The transversus abdominis plane (TAP) block is one of the abdominal field blocks used in the treatment of acute postoperative pain after lower abdominal surgery. This study aims to investigate the effects of dexamethasone added to a local anesthetic solution on postoperative analgesia in ultrasonography-guided TAP block. MATERIALS AND

methodsOur study included female patients aged 18-80 with American Society of Anesthesiology (ASA) I-II status who had undergone gynecological laparotomy (total abdominal hysterectomy (TAH), total abdominal hysterectomy + bilateral salpingoophorectomy (TAH+BSO), myomectomy). The patients were examined in two groups, each consisting of 30 people. Patients in whom dexamethasone was added to the analgesic solution while applying the TAP block were classified as Group D and patients without dexamethasone were classified as Group B. The patients' Visual Analog Scale (VAS) scores at the 2nd, 4th, 8th, 12th, and 24th hours postoperatively; their painkiller needs in the first 24 hours postoperatively; their first mobilization time; and their total analgesic requirements in the first 24 hours postoperatively were examined.

resultsWhen postoperative 2, 4, 8, and 12 hours VAS scores were compared, no significant difference was found between the groups (p>0.05). Postoperative 24th-hour VAS scores were significantly lower in Group D (p<0.001). No statistically significant difference was found when additional analgesic demands were compared between the groups at 2, 4, 8, and 12 hours postoperatively (p>0.05). Additional analgesic demand at the 24th postoperative hour was significantly lower in Group D (p=0.020). When the 24-hour additional IV analgesic demands of the patients were compared, the additional analgesic demand in Group B was found to be significantly higher than in Group D (p=0.038). When postoperative mobilization hours were compared between the groups, no statistically significant difference was found between the two groups (p=0.617). When the patient's first analgesic request times were compared, no significant difference was found between the groups (p=0.617).

conclusionIt was determined that dexamethasone added to bupivacaine in USG-guided TAP block reduced the amount of additional analgesic consumed in the first 24 hours postoperatively and reduced VAS scores. We think that adding dexamethasone to local anesthetics in the TAP block will benefit multimodal analgesia.