A Clinical Comparative Study of the Efficacy of Post-Operative Analgesia in Pregnant Females Undergoing LSCS with USG-Guided TAB Block Using 0.3% Ropivacaine with Fentanyl, Dexmedetomidine and Dexamethasone as Adjuvants

Abstract

Aim: to study and compare the efficacy of USG-guided TAB block with Fentanyl, Dexmedetomidine and Dexamethasone as an add-on to 0.3% ropivacaine.

Materials and methods: This prospective comparative study was conducted in pregnant females undergoing Lower Segment Cesarean Section (LSCS) by the Department of Anesthesia of Saveetha Medical College, a tertiary care hospital. The intervention involves the use of Ultrasound-Guided Transversus Abdominis Block (TAB) with 0.3% ropivacaine, with the addition of fentanyl or dexmedetomidine or dexamethasone as adjuvants. This study was conducted after approval from the Institutional Review Board (IRB) and written informed consent was obtained from all study participants.

Results: The mean age of the participants in the dexmedetomidine group was 28.3 ± 5.86 years and in the dexamethasone, group was 28.45 ± 5.88 and in fentanyl group was 26.20 ± 3.888. The p-value was 0.9360 which shows that the age group in all the groups was comparable to each other. Participants in Group 1 experienced a mean duration of postoperative analgesia of 16.8 hours (SD: 3.1), with a range from 19 to 26 hours and participants in Group 2 experienced a mean duration of postoperative analgesia of 18.5 hours (SD: 2.3), ranging from 11 to 18 hours and group 3 experienced a mean duration of postoperative analgesia of 18.9 (SD:1.9) hrs as shown in figure 1. The p-value was < 0.0001 which was statistically significant in favor of group 1. Maternal satisfaction scores in Group 1 had a mean value of 9.2 (SD: 0.9), with responses ranging from 8 to 10. Participants in Group 2 had a mean value of 8.4 (SD: 1.2), with responses ranging from 7 to 10. In group 3 participants maternal satisfaction scores had a mean value of 9.0 (SD: 0.8), with responses ranging from 8 to 10, with a p-value of 0.022 in favor of group 1.

Conclusion: The incidence of adverse effects in both groups was limited and comparable, emphasizing the safety of these adjuvants in the context of regional anesthesia for cesarean sections. Maternal satisfaction scores were high in both groups, highlighting the overall positive experience with postoperative pain management in the dexmedetomidine group.