Efficacy of Dexmedetomidine as an Adjuvant to Ropivacaine in Ultrasound-Guided Transversus Abdominis Plane Block for Postoperative Analgesia in Lower Abdominal Surgeries: A Prospective, Randomized, Double-Blind Study

Background: Adequate postoperative analgesia is crucial for optimal recovery following lower abdominal surgeries. The transversus abdominis plane (TAP) block has emerged as an effective regional anesthetic technique. This study evaluated the efficacy of adding dexmedetomidine to ropivacaine in an ultrasound-guided TAP block for postoperative pain management. Materials and Methods: This prospective, randomized, double-blind study included 120 patients (American Society of Anesthesiologists I–II) aged 18–60 years undergoing elective lower abdominal surgeries. Patients were randomly allocated to two groups: Group A ( n = 60) received 19.5 mL of 0.375% ropivacaine + 0.5 mL of normal saline, whereas Group B ( n = 60) received 19.5 mL of 0.375% ropivacaine + 0.5 mL of dexmedetomidine (50 μg) in an ultrasound-guided TAP block. The primary outcome was postoperative pain assessed using the Numeric Rating Scale (NRS) over 24 h. Secondary outcomes included time to first rescue analgesia, total analgesic consumption, and patient satisfaction. Results: Both groups were comparable in demographic and baseline characteristics. NRS scores were significantly lower in Group B at 6 h (2.01 ± 0.39 vs 2.4 ± 0.76, P = 0.004), 8 h (2.13 ± 0.75 vs 2.80 ± 0.95, P < 0.001), 14 h (2.02 ± 0.89 vs 2.33 ± 0.66, P = 0.020), 16 h (2.05 ± 0.72 vs 2.63 ± 0.86, P < 0.001), and 18 h (2.28 ± 0.74 vs 2.98 ± 0.95, P < 0.001). Time to first rescue analgesia was significantly prolonged in Group B (12.19 ± 3.87 vs 10.46 ± 3.06 h, P = 0.003). Total analgesic consumption was lower in Group B (1.58 ± 0.72 vs 1.83 ± 0.56 ampoules, P = 0.036). Patient satisfaction was significantly higher in Group B (3.76 ± 0.46 vs 3.37 ± 0.64, P = 0.001). Seven patients (11.67%) in Group B required no rescue analgesia over 24 h versus none in Group A ( P = 0.019). Conclusion: The addition of 50 μg dexmedetomidine to 0.375% ropivacaine in an ultrasound-guided TAP block significantly improves postoperative analgesia, prolongs the time to first rescue analgesia, reduces total analgesic consumption, and enhances patient satisfaction in lower abdominal surgeries without significant adverse effects.