A Comparative study between Analgesic Efficacy of Levobupivacaine and Buprenorphine v/s Levobupivacaine and Dexamethasone in Transversus Abdominis Plane block following a Caesarian Delivery

Abstract

Objective: The aim of this study was to evaluate and compare the post operative analgesic efficacy of Levobupivacaine and Buprenorphine v/s Levobupivacaine and Dexamethasone following a Transversus Abdominis Plane block in a patient following a caesarean section. Materials and Methods: Fifty-Two American Society of Anaesthesiologists grade I and II pregnant women aged between 20 and 40 years requiring lower segment caesarean section were included in this study. Study Design: A Prospective, Double Blinded, Randomized Comparative Study. Study Groups: Group LB Patients received 19.5 ml 0.25% Levobupivacaine with 0.5 ml (150 mcg) Buprenorphine in TAP BLOCK (total volume 20 ml) given on each side of Abdomen and Group LD Patients received 19.5 ml 0.25% Levobupivacaine with 0.5 ml (2 mg Dexamethasone) in TAP BLOCK (total volume 20 ml) given on each side of Abdomen. Results: The time to first rescue analgesic requirement was significantly longer in Group LB than in Group LD (680.79 ± 28.10 min, 593.40 ± 31.80 min, respectively; P < 0.001) The mean total tramadol consumption in first 24 hours was lower in Group LB than compared to Group LD (150.10 ± 40.10 mg, 174.10 ± 22.40 mg, respectively; P value is 0.0104 considered significant). Group LB displayed significantly lower VAS Score both at rest and movement than Group LD. Conclusion: Levobupivacaine with Buprenorphine in TAP block after caesarean section facilitates prolonged analgesia and reduced requirements for rescue analgesia compared to Levobupivacaine with Dexamethasone, without significant side effects.