A Randomised Controlled Trial to Assess the Analgesic Efficacy of Reduced Dose 0.2% Ropivacaine–Dexmedetomidine Combination Compared to Standard 0.375% Ropivacaine in USG Guided TAP Block for Paediatric Hernia Repair
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Original Article
P: 304-311
August 2021

A Randomised Controlled Trial to Assess the Analgesic Efficacy of Reduced Dose 0.2% Ropivacaine–Dexmedetomidine Combination Compared to Standard 0.375% Ropivacaine in USG Guided TAP Block for Paediatric Hernia Repair

Turk J Anaesthesiol Reanim 2021;49(4):304-311
1. Department of Anaesthesiology and Critical Care, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India
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Received Date: 01.06.2020
Accepted Date: 17.08.2020
Publish Date: 03.08.2021
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ABSTRACT

Objective:

Paediatric pain management has remained understated practice over a period of time. Recently ultrasound-guided (USG) guided techniques are gaining popularity for perioperative analgesia, especially in the paediatric population. So, the aim of the present study was to evaluate the efficacy of reduced dose ropivacaine–dexmedetomidine combination compared to standard 0.375% ropivacaine in USG guided transversus abdominis plane (TAP) block.

Conclusion:

Combination of 1 mg kg1 dexmedetomidine with reduced concentration of ropivacaine (0.2%) produced significantly longer duration of post-operative analgesia and lowered post-operative CHEOPS pain score in comparison with 0.375% ropivacaine alone in USG guided TAP block for paediatric hernia repair.

Results:

Time to first rescue analgesia in group RD and group R were 16.32 6 3.11 hours and 10.82 6 2.16 hours, respectively (P < .0001). Mean CHEOPS score were 4.48 6 1.1 and 6.3 6 1.74 (P < .024) in group RD and R. Post-op Ramsay sedation score was significantly greater in group RD. Heart rate and blood pressure remained similar in either of the group. No episode of respiratory depression, bradycardia or hypotension was noted perioperatively.

Methods:

Sixty children of either sex, aged 2–10 years, posted for elective open herniotomy under general anaesthesia were randomly divided into two groups of 30 patients each. Group RD received 0.2% ropivacaine with dexmedetomidine 1 mg kg1 while group R received 0.375% ropivacaine at 0.5mL kg1. Meantime to first rescue and total analgesics, Children’s Hospital of Eastern Ontario Pain Scale (CHEOPS) and Ramsay sedation score, haemodynamic parameters and adverse effects were noted.