الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Ultrasound-guided transversus abdominis plane (TAP) block became a common analgesic method after surgery involving the abdominal wall. Different adjuvants have been used to intensify the quality and the duration of local anesthetics.
The aim of this study is to compare dexmedetomidine versus dexamethasone added to bupivacaine as adjuvant to the local anesthetic bupivacaine during Ultrasound-guided transversus abdominis plane (TAP) block for postoperative analgesia in laparoscopic cholecystectomy , characteristics including duration of postoperative analgesia, post-operative pain score and sedation score.
In the current study, 40 patients scheduled for elective laparoscopic cholecystectomy surgery were given Ultrasound-guided transversus abdominis plane (TAP) block after induction of general anesthesia. The patients were randomly allocated into two groups. group (DM):patients received 22 ml of Bupivacaine 0.25 %in 20 ml + 1ug/kg of dexmedetomidine in 2ml on both sides. group (DS): patients received 22 ml of Bupivacaine 0.25 % in 20ml + 4mg of dexamethasone in 2ml on both sides.
Our study concluded that co administration of 1ug/kg of dexmedetomidine vs dexamethasone 4mg to 0.25 % bupivacaine on both sides by US guided TAP block leaded to significant changes in the form of lower HR at 12,24,48hrs, lower sedation score at 1,6,12,24,48hrs and no significant changes in systolic blood pressure, diastolic blood pressure, oxygen saturation and respiratory rate.
VAS pain score at rest especially 6,12, 24,48hrs is significantly less in dexmedetomidine group than in dexamethasone group.
VAS pain score at movement especially 6,12,24,48hrs is significantly less in dexmedetomidine group than in dexamethasone group.
1st rescue dose of analgesics was delayed up to (19.76±2.51hrs), in dexmedetomidine group in comparison to (12.92±2.17hrs) in dexamethasone group.
The total dose of paracetamol required by patients in the dexmedetomidine group was ( 3.18±1.07 gm) compared to (5.33±1.16 gm) in dexamethasone group, indicating longer pain-free period and less requirement of analgesia in the dexmedetomidine group. Therefore, use of dexmedetomidine in TAP block has a beneficial effect in reducing the dose of systemic analgesic requirements.