TO COMPARE THE ANALGESIC EFFICACY OF 0.25% BUPIVACAINE AND 0.25% ROPIVACAINE IN TAP BLOCK AS A PART OF A MULTIMODAL ANALGESIA REGIMEN FOR POST CAESAREAN DELIVERY PAIN MANAGEMENT
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 9
Abstract
BACKGROUND Women having a caesarean delivery present a unique set of challenges to the Anaesthetist postoperatively. They need to be alert, comfortable and ambulant in order to care for their newborn.[1] As part of a multimodal analgesic regimen, Opioids and NSAIDs are required initially to achieve effective analgesia. This study is intended to evaluate the analgesic efficacy of 0.25% Bupivacaine and 0.25% Ropivacaine in TAP block as a part of multimodal analgesia regimen over the first 24 postoperative hours after lower segment caesarean section. MATERIALS AND METHODS In a prospective, randomised, controlled, double-blinded study sixty parturient of American Society of Anesthesiologist’s (ASA) physical status I and II undergoing lower segment caesarean section were randomised to undergo a bilateral TAP block with Bupivacaine 0.25% (Group A= 30) and Ropivacaine 0.25% (Group B= 30). In addition, all patients received standard analgesic injection tramadol 2 mg/kg and IV injection diclofenac 75 mg as required in the postoperative period. All patients received standard spinal anaesthesia and TAP block was performed at the end of surgery. Each patient was assessed after operation at 2, 4, 6, 12, 24 hours after surgery in postoperative period. RESULTS The mean visual analogue scale (VAS) score of Group A was less than mean VAS score of Group B at all-time interval, but was not statistically significant (p > 0.05). The mean time to first rescue analgesia in Group A was 434.166 ± 213.035 min and in Group B it was 436.875 ± 170.229 min, which was not significant statistically (p > 0.05). CONCLUSION Transversus abdominis plane block holds considerable promise as part of a multimodal analgesic regimen for post caesarean delivery analgesia. The conclusion of our study is that 0.25% Bupivacaine and 0.25% Ropivacaine are equally effective in TAP block and provides effective postoperative analgesia.
Authors and Affiliations
Meghna Maheshwari, Vimal Dangi, Sadhana Sanwatsarkar, Janki Singh
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