Evaluation of the Efficacy of 0.20% Ropivacaine with Dexmedetomidine versus 0.20% Ropivacaine Alone for Transversus Abdominis Plane Block in Infra-Umbilical Surgery: A Randomized Controlled Study

Dr. Nihar Ranjan Pradhan, Dr. Sucheta Pattnayak

Abstract: Background: Postoperative pain management is a critical component of surgical recovery. The Transversus Abdominis Plane (TAP) block has emerged as an effective regional anesthesia technique for abdominal surgeries. This study evaluates the efficacy of adding dexmedetomidine to ropivacaine in TAP blocks to enhance postoperative analgesia. Methods: This prospective, randomized, double - blinded, controlled study was conducted at the Department of Anaesthesiology, HITECH Medical College and Hospital, Bhubaneswar, from 2023 to 2025. Sixty ASA I - II patients, aged 18?60, undergoing infra - umbilical surgery under spinal anesthesia were randomized into two groups: RS (0.20% Ropivacaine with saline) and RD (0.20% Ropivacaine with dexmedetomidine 1 mcg/kg). Postoperative analgesia was assessed using the Visual Analog Scale (VAS), time to first rescue analgesia, total tramadol consumption, and hemodynamic parameters. Results: Patients in the RD group had significantly prolonged analgesia compared to the RS group (10.80?6.38 vs.2.80?0.99 hours, p<0.001). VAS scores were significantly lower in RD at all time points. Total tramadol consumption was significantly reduced in RD (48.33?20.69 mg vs.105?15.25 mg, p<0.001). No significant adverse effects were noted. Conclusion: The addition of dexmedetomidine to ropivacaine in TAP block significantly prolongs analgesia, reduces opioid consumption, and enhances patient comfort without notable side effects. This combination can be recommended for improved postoperative pain management in infra - umbilical surgeries.

Keywords: TAP block, ropivacaine, dexmedetomidine, postoperative analgesia, infra - umbilical surgery