Key result
Addition of either 4 mg or 8 mg of dexamethasone to bupivacaine in a transversus abdominis plane block eliminated the need for rescue analgesia in the first 24 hours postoperatively compared to a time to first request of 720 minutes with bupivacaine alone.
Why the study?
The study aimed to compare the analgesic efficacy of two different doses of dexamethasone (4 mg and 8 mg) added to bupivacaine in a unilateral single-injection TAP block.
Does adding 4 mg or 8 mg of dexamethasone to bupivacaine in a TAP block improve postoperative analgesia in male patients undergoing inguinal hernia repair?
RCT (n=90)
Double-blind
Computer-generated randomized tables
No
Does adding 4 mg or 8 mg of dexamethasone to bupivacaine in a TAP block improve postoperative analgesia in male patients undergoing inguinal hernia repair?
Absolute Event Rate: 1440% vs 720%
Adding either 4 mg or 8 mg of dexamethasone to bupivacaine in a TAP block provides equivalent and significantly prolonged postoperative analgesia compared to bupivacaine alone for inguinal hernia repair.
Dexamethasone addition to TAP block prevents 24-h rescue analgesia after hernia repair; confirms efficacy without dose advantage of 8 mg versus 4 mg.
Background Ninety patients American Society of Anesthesiologists (ASA) I–II, aged (18–60 years), were enrolled in this randomized controlled trial. All enrolled patients had undergone elective primary unilateral open inguinal hernia repair under spinal anesthesia; at the end of the surgery, transversus abdominis plane (TAP) block was done by bupivacaine combined with 4 mg dexamethasone in (group I), 8 mg dexamethasone in (group II), or saline in (group III.). We aimed to compare the analgesic efficacy of two different doses of dexamethasone (4 mg and 8 mg) added to bupivacaine in a unilateral single-injection (TAP) block. The first outcome measure was the time of the first analgesic request, and the secondary outcome measure was the VAS scale in the first postoperative 24 h. Results There was no need for any analgesia in group I and group II in the first postoperative 24 h. The time of the first analgesic request in group III was 720 ± 90 min. VAS scores were significantly lower in group I and group II than in group III, with no significant difference between group I and group II. Conclusions There is no difference in the first postoperative 24 h analgesic effect of the two doses of dexamethasone when added to a long-acting local anesthetic mixture in TAP blocks in patients undergoing inguinal hernia repair. Trial registration ClinicalTrials.gov, NCT03863977
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Abdel‐Wahab et al. (2021) conducted an RCT in Inguinal hernia (n=90). Dexamethasone added to bupivacaine in transversus abdominis plane (TAP) block vs. Bupivacaine with saline was evaluated on Time of the first analgesic request (in minutes). Addition of either 4 mg or 8 mg of dexamethasone to bupivacaine in a transversus abdominis plane block eliminated the need for rescue analgesia in the first 24 hours postoperatively compared to a time to first request of 720 minutes with bupivacaine alone.
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