Effects of the dexamethasone added to levobupivacaine used in ultrasound guided TAP block for analgesia in cesarean delivery

Transabdominal plane block is one of the new techniques applied for postoperative pain control after cesarean delivery. Dexamethasone is a steroid agent which has analgesic, anti-inflammatory and anti-emetic properties. Many adjuvant agents were used to enhance the effects, reduce the toxicity of local anesthetic agents, and to prolong duration of block. We aimed to investigate the effects of dexamethasone added to local anesthetic, on analgesia, the duration of TAP block and nausea-vomiting.We studied 42 ASA I-II patients aged between 20-40, planned for cesarean delivery under spinal anesthesia in a randomized, double-blinded study. We performed US-guided TAP block at the end of surgery for both groups. A 100 mm long and 20 G needle was introduced through the skin anteriorly and advanced into fascial plane between the internal oblique and the transversus abdominis muscles. Grup L is received 30 ml 0.25% levobupivacaine and 2 ml saline, group D was received 30 ml 0.25% levobupivacaine and 2 ml dexamethasone on each side with the TAP block. We recorded sistolic (SAP), diastolic(DAP) and mean arterial blood pressure(MAP), heart rate(HR), respiratory rate(RR), peripheral oxygen saturation, VAS I and VAS II scores at 1,2,4,8,12,16 and 24 h after surgery. And also time to first analgesic drug request, total analgesic requirements over 24 hours, nausea, vomiting, patient and surgery satistification were recorded for both groups. There was no significant difference in demographic data, (SAP), (DAP), (MAP), HR, RR, nausea and vomiting between the groups. VAS I and VAS II scores were significantly lower, the time to first analgesic drug request was longer, patient and surgery satistification were higher in group D. And also total analgesic drug consumption was significantly lower in group D.In conclusion, our study showed that, dexamethasone added to levobupivacaine in TAP block, reduces VAS I and II, increases the duration of analgesia, quality of block and improves patient satistification, reduces total analgesic drug consumption.Key words: Cesarean Delivery, Postoperative pain, TAP block, Levobupivacaine, Dexamethasone