title: Effect of Adding Dexamethasone as a Ropivacaine Adjuvant in Ultrasound-Guided Transversus Abdominis Plane Block for Inguinal Hernia Repair.
abstract: BACKGROUND
  The transverses abdominals plane block (TAP) is a regional anesthesia technique that provided analgesia to the parietal peritoneum, skin and muscles of the anterior abdominal wall. The aim of this randomized double-blind study was to evaluate postoperative analgesia on patients undergoing open inguinal hernia repair under general anesthesia (GA), (GA + TAP) block preformed with ropivacaine and (GA + TAP-D) block preformed with ropivacaine and 4 mg dexamethasone.
  
  
  METHODS
  90 (ASA I-II) adult patients for unilateral open inguinal hernia repair were included in this study. In group I (n = 30) patents received only general anesthesia (GA). Patients in group II (n = 30) received GA and unilateral TAP block with 25 ml of 0.5% ropivacaine and the patients in group III (n = 30) received GA and unilateral TAP-D block with 25 ml of 0.5% ropivacaine + 4 mg Dexamethadsone. In this study we assessed the pain score - VAS at rest at 2, 4, 6, 12 and 24 hours after the operation and the total analgesic consumption of morphine over 24 hours.
  
  
  RESULTS
  There were statistically significant differences in the VAS scores between group I, group II and group III at all postoperative time points - 2(hr), 4(hr), 6(hr), 12(hr) and 24(hr). (p < 0.00001). The cumulative 24 hours morphine consumption after the operation was significantly lower in group III (5.53 1.21 mg) than in group II (6.16 2.41 mg) and group I (9.26 2.41 mg). This difference is statistically significant (p < 0.00001).
  
  
  CONCLUSIONS
  Concerning the inguinal hernia repair we found better postoperative pain scores and 24 hours reduction of the morphine consumption in group III (GA and TAP-D block) compared with group I (GA) and group II (GA + TAP block).
authors.forename: Andrijan
authors.initials: A
authors.lastname: Kartalov
authors.forename: Nikola
authors.initials: N
authors.lastname: Jankulovski
authors.forename: Biljana
authors.initials: B
authors.lastname: Kuzmanovska
authors.forename: Milka
authors.initials: M
authors.lastname: Zdravkovska
authors.forename: Mirjana
authors.initials: M
authors.lastname: Shosholcheva
authors.forename: Tatjana
authors.initials: T
authors.lastname: Spirovska
authors.forename: Aleksandra Panovska
authors.initials: AP
authors.lastname: Petrusheva
authors.forename: Marija
authors.initials: M
authors.lastname: Tolevska
authors.forename: Marija
authors.initials: M
authors.lastname: Srceva
authors.forename: Vesna
authors.initials: V
authors.lastname: Durnev
authors.forename: Gjorgji
authors.initials: G
authors.lastname: Jota
authors.forename: Redzep
authors.initials: R
authors.lastname: Selmani
authors.forename: Atanas
authors.initials: A
authors.lastname: Sivevski
mesh_terms: D000009:Abdominal Muscles / Q000000981:diagnostic imaging* / Q000294:innervation*; D000759:Adjuvants, Anesthesia / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000577:Amides / Q000008:administration & dosage* / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000768:Anesthesia, General; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D003907:Dexamethasone / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D006552:Hernia, Inguinal / Q000175:diagnosis / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D018843:Republic of North Macedonia; D000077212:Ropivacaine; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D000759:Adjuvants, Anesthesia; D000577:Amides; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D000077212:Ropivacaine; D003907:Dexamethasone