title: Dexamethasone added to levobupivacaine in ultrasound-guided tranversus abdominis plain block increased the duration of postoperative analgesia after caesarean section: a randomized, double blind, controlled trial.
abstract: OBJECTIVE
  When added to local anaesthetics, dexamethasone can prolong the duration of peripheral blocks. Dexamethasone has a long and efficient glucocorticoid structure and presents anti-inflammatory properties. The aim of this study was to determine the effect of dexamethasone on the block duration added to levobupivacaine used for transversus abdominis block (TAP) applied to patients who underwent caesarean section.
  
  
  METHODS
  Forty-two patients with spinal anaesthesia in an American Society of Anesthesiologists (ASA) I-II risk group were included in the study and divided into two groups. Bilateral 30 ml 0.25% levobupivacaine and 2 ml 0.9% NaCl for the levobupivacaine group and bilateral 30 ml 0.25% levobupivacaine and 2 ml dexamethasone (8 mg) for the dexamethasone group were administered in a TAP block performed with ultrasonography. The time need for the first analgesic in the postoperative period was recorded. The numeric evaluation scale, and the total additional analgesic amounts were recorded.
  
  
  RESULTS
  The time before the administration of the first additional analgesic dose was prolonged significantly in the dexamethasone group compared to the levobupivacaine group (p = 0.004). The pain scores were lower in the dexamethasone group for superficial pain. A significant difference for the dexamethasone group was observed in the evaluation of deep pain. The total consumption of tramadol was significantly lower in the dexamethasone group (p = 0.001).
  
  
  CONCLUSIONS
  The utilization of dexamethasone, which has a prolonging effect on the transversus abdominis plane block, may be an alternative to epidural opioid analgesia in caesarean section. We observed that dexamethasone added to levobupivacaine in a TAP block applied for analgesia following a caesarean section procedure prolonged the time required for analgesia.
authors.affiliation: Department of Anaesthesiology and Reanimation, Abant Izzet Baysal University Medical Faculty, Bolu, Turkey. akcanakkaya@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Akkaya
authors.forename: I
authors.initials: I
authors.lastname: Yildiz
authors.forename: U Y
authors.initials: UY
authors.lastname: Tekelioglu
authors.forename: A
authors.initials: A
authors.lastname: Demirhan
authors.forename: H
authors.initials: H
authors.lastname: Bayir
authors.forename: T
authors.initials: T
authors.lastname: Ozlu
authors.forename: M
authors.initials: M
authors.lastname: Bilgi
authors.forename: H
authors.initials: H
authors.lastname: Kocoglu
mesh_terms: D000009:Abdominal Muscles; D000328:Adult; D015360:Analgesia, Epidural / Q000379:methods; D016362:Analgesia, Obstetrical / Q000379:methods; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D002585:Cesarean Section / Q000009:adverse effects*; D003907:Dexamethasone / Q000008:administration & dosage*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D000077554:Levobupivacaine; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D011247:Pregnancy; D018084:Ultrasonography, Interventional / Q000379:methods*; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D003907:Dexamethasone; D000077554:Levobupivacaine; D002045:Bupivacaine