Indian Journal of Obstetrics and Gynecology Research 2019;6(4):492–494 Content available at: iponlinejournal.com Indian Journal of Obstetrics and Gynecology Research Journal homepage: www.innovativepublication.com Original Research Article Comparison of the efficacy of bupivacaine versus bupivacaine plus dexamethasone during surgical TAP block for post operative analgesia after caesarean section Supriya Jagdale 1 , Aniket S Kakade 1, *, Girija Wagh 1 1 Dept. of Obstetrics and Gynecology, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune, Maharashtra, India ARTICLE INFO Article history: Received 13-06-2019 Accepted 31-08-2019 Available online 06-12-2019 Keywords: Transversus abdominis plane block Bupivacaine Dexamethasone Surgical TAP block Caesarean delivery ABSTRACT Introduction and Aim: 1: Dexamethasone is steroid which can be used as add on to local anesthetic for prolonging the duration of action and has been studied in different neuroaxial blocks. We undertake this study by comparing the efficacy of bupivacaine alone versus bupivacaine plus dexamethasone during the surgical TAP block during caesarean section; 2: To correlate the advantages, disadvantages and adverse effects of the drugs during the surgical TAP block. Methods and Materials: A double blind randomized control study to include 100 women was approved by the institutional ethics committee. Patients were randomized as Group A: received surgical TAP block with Bupivacaine alone. Group B: received TAP block with Bupivacaine plus dexamethasone. Dose of the drug was adjusted with respect to the weight of the patient and surgical TAP block was administered via trans-peritoneal route. Visual analogue score (VAS) was assessed by a blinded observer. Time required for rescue analgesia in minutes was measured. The ’Mann-Whitney U test’ was used for statistical analysis. Results: The duration of post operative analgesi a was prolonged in group B. Group A Bupivacaine had post op duration of analgesia (mean± SD 268.80±125.53 minutes), Group B Bupivacaine plus dexamethasone had post op duration of analgesia (mean± SD 466.8±207.86). There were no reported complications during the surgical technique or any adverse effects to bupivacaine and dexamethasone administered for the TAP block. Conclusion: Surgical TAP block with bupivacaine plus dexamethasone is more effective than with bupivacaine alone. © 2019 Published by Innovative Publication. This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by/4.0/) 1. Introduction A lower segment caesarean section commonly induces moderate to severe post operative pain for 48 hours. 1 Adeqate pain relief should be provided to post caesarean patients. TAP block is a regional block anesthesia technique that earmarks the sensory nerve supply of anterior and lateral abdominal wall and has been proven as an effective method to reduce postoperative pain and analgesic requirement for lower abdominal surgeries in various clinical trials. 2,3 * Corresponding author. E-mail address: jagdalesupriya19@gmail.com (A. S. Kakade). The TAP block can be performed successfully using any one of the three techniques: the blind technique, ultrasound directed technique and the surgical TAP block by the operating surgeon. The surgical TAP block technique has the distinct advantages of maintenance of asepsis, visible and easy maneuverability of the needle and tactile confirmation of correct needle placement and no added risks. Regional bupivacaine alone is short lived. 4 Adjuvant may be used to prolong the local analgesia duration. 5 Dexamethasone due to its anti inflammatory and blocking effects on neural discharge and nociceptor C fibers transmission could be used as a local anesthetic adjuvant. 6 https://doi.org/10.18231/j.ijogr.2019.106 2394-2746/© 2019 Innovative Publication, All rights reserved. 492