Perioperative analgesic effect of preemptive ultrasound-guided rectus sheath block and transversus abdominis plane block with dexmedetomidine versus dexamethasone for laparoscopic surgery in paediatrics: A randomised trial.

BACKGROUND

We aimed to assess the impact of the rectus sheath and transversus abdominis plane blocks on postoperative pain alleviation and recovery in children undergoing laparoscopic appendicectomies.

METHODS

Ninety patients got a transversus abdominis plane block and rectus sheath block and were randomly divided into three groups. Each patient had taken 2.5ml of 0.5% bupivacaine (1.25mg/kg). Group 1: 0.3mg/kg of dexamethasone was added to the bupivacaine. Group 2: 1μg/kg of dexmedetomidine was added to the bupivacaine. Group 3: received only bupivacaine. We recorded analgesic usage overall, postoperative pain score, time until initial analgesic use, side effects and satisfaction score.

RESULTS

The dexmedetomidine group had a significantly longer mean time to initial rescue analgesia (13.13 ± 2.81) compared to the control and dexamethasone groups (11.6 ± 2.99, 7.27 ± 2; p < 0.001). Within the first 24 hours following surgery, the dexmedetomidine group consumed considerably less rescue analgesia (490.5 ± 129) than the dexamethasone and control groups (556 ± 210.4, 811.5 ± 333.9; p < 0.0001). With better satisfaction, fewer analgesics were taken, and fewer side effects and lower postoperative pain levels were observed in the dexmedetomidine group.

CONCLUSIONS

Dexmedetomidine in combined transversus abdominis plane and rectus sheath blocks can enhance postoperative pain relief, decrease analgesic use and hasten postoperative recovery.