Transversus Abdominis Plane Block With Dexamethasone and Dexmedetomidine Decreases Opioid Consumption, Length of Stay, and Ileus After Laparoscopic Colorectal Resection.

BACKGROUND

This study investigated the impact of transversus abdominis plane (TAP) blocks containing bupivacaine hydrochloride, dexamethasone, and dexmedetomidine on postoperative outcomes following laparoscopic colorectal resections.

PATIENTS AND

METHODS

This retrospective cohort study included patients who had undergone elective laparoscopic colorectal resections between 2019 and 2022. Patients received either local wound infiltration or TAP blocks. TAP blocks were comprised of bupivacaine hydrochloride, dexamethasone, and dexmedetomidine. Local infiltration was with bupivacaine alone. Postoperative morphine milligram equivalents (MME) and visual analog scale (VAS) scores were compared. Predictors of MME and length of stay (LOS) were investigated by multiple linear regression.

RESULTS

A total of 195 patients met the inclusion criteria. Among them, 90 (46.1%) received local wound infiltration, while 105 (53.9%) received TAP blocks. Patients in the TAP block group experienced lower postoperative MME at 24 hours (49.9 mg vs. 77.33 mg, p = 0.028) and a shorter LOS of 4.4 ± 2.2 days compared to 6.1 ± 5.1 days (p = 0.001). VAS scores showed statistically similar results between treatment groups at all three postoperative time points. Additionally, TAP blocks were associated with a reduced incidence of postoperative ileus (0% vs. 5%, p = 0.01). Multiple linear regression indicated that TAP blocks were independently associated with lower MME at 24 hours after surgery (β = -31.3, 95% CI: -57.5 to -5.1, p = 0.019) and a shorter LOS (β = -1.9, 95% CI: -3.4 to -0.4, p = 0.013).

CONCLUSION

TAP blocks using bupivacaine, dexamethasone, and dexmedetomidine are associated with decreased opioid consumption at 24 hours, shorter LOS, and reduced ileus compared to local infiltration alone.