الفهرس 
Introduction and Aim of the workOnly 14 pages are availabe for public view
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Abstract
SUMMARY
The use of ultrasound for the placement of peripheral nerve blocks has received a great deal of attention lately in the anesthesiology literature and is beginning to solidify a place in clinical practice. Claimed benefits of ultrasound-guided regional anesthesia include that it is easier to learn and quicker to perform, has a faster onset, results in higher success rates, results in more complete blocks, requires lower volumes of local anesthetic, and increases safety.
A substantial component of the pain experienced by patients after abdominal surgery is derived from the abdominal wall incision. The abdominal wall is innervated by nerve afferents that course through the transversus abdominisneuro-fascial plane.
Abdominal field blocks have been around for a long time and have been extensively used. They, however, provide limited analgesic fields; hence multiple injections are usually required. Traditionally these blocks have blind end points (pops) making their success unpredictable.
The description of the landmark technique for performing posterior transversus abdominis plane (TAP) block advocated a single entry point, the triangle of Petit, to access a number of abdominal wall nerves hence providing more widespread analgesia. More recently, ultrasound guided TAP block has been described with promises of better localization and deposition of the local anesthetic with improved accuracy.
Our study demonstrates that real time ultrasound guided combined TAPB with dexamethasone provides additional benefit to multimodal analgesia more than the real time ultrasound guided TAP block alone in sixty females undergoing cesarean section. The patients who received the combined block required less postoperative analgesic requirements.
There were no recorded complications related to the block techniques in all patients who received either block either intra or postoperatively in the form of hemodynamic instability, injury to underlying structures, hematoma formation, infection. Patient satisfaction was markedly observed in case of combined TAPB using dexamethasone added to levobupivacain block than in TAPB alone.