Efficacy of Dexmedetomidine Added to Ropivacaine for Four-Quadrant Transversus Abdominis Plane Blocks on Hemodynamic Response and Postoperative Analgesia in Laparoscopic Cholecystectomy

Background Laparoscopic cholecystectomy, though minimally invasive, is associated with a significant perioperative stress response and postoperative pain. Ultrasound-guided transversus abdominis plane (TAP) block is an effective regional analgesic technique, and the addition of adjuvants such as dexmedetomidine may enhance its efficacy. The aim of the present study is to evaluate the efficacy of adding dexmedetomidine to ropivacaine in four-quadrant ultrasound-guided TAP blocks on intraoperative hemodynamic responses and postoperative analgesia in patients undergoing laparoscopic cholecystectomy. Materials and methods This prospective, randomised, double-blind, controlled study was conducted at a tertiary care centre. A total of 126 American Society of Anesthesiologists physical status I and II patients undergoing elective laparoscopic cholecystectomy were randomised into three groups (n=42 each): Group RD received a TAP block with 0.2% ropivacaine plus dexmedetomidine 0.5 µg/kg; Group R received a TAP block with 0.2% ropivacaine alone; and Group C served as a control group and did not receive a TAP block. Intraoperative heart rate and blood pressure were recorded at predefined intervals. Postoperative pain was assessed using the visual analogue scale (VAS), and the time to the first dose of rescue analgesia was recorded. Results Demographic parameters were comparable across the groups. Intraoperative heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure were significantly lower in Group RD than in Groups R and C at most time intervals (p < 0.05). Postoperative VAS scores at one and four hours were significantly lower in Group RD (p < 0.001), and the time to the need for rescue analgesia was longer in Group RD than in the other groups. Conclusion The addition of dexmedetomidine to ropivacaine in ultrasound-guided TAP blocks provides superior intraoperative hemodynamic stability and enhanced postoperative analgesia compared with ropivacaine alone or no TAP block in patients undergoing laparoscopic cholecystectomy.