POSTOPERATIVE PAIN MANAGEMENT BY FENTANYL VS DEXMEDETOMIDINE AS AN ADJUVANT WITH ROPIVACAINE BY TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK IN INFRA UMBILICAL SURGERIES UNDER SPINAL ANAESTHESIS: A COMPARATIVE STUDY

Introduction: The analgesia effect of anesthetic drugs namely Ropivacaine, can further be enhanced with adjuvants. For postoperative pain management in infra-umbilical surgeries, Ropivacaine with an adjuvant can be used through a Transversus Abdominis Plane (TAP) block, which is a simple and clinical anatomical landmark procedure, suitable in remote areas without advanced modern technical tools. Aims: Fentanyl and Dexmedetomidine (Dexmed) were used as adjuvant to Ropivacaine, injected in TAP, postoperatively, and were compared in terms of pain relief. Material & Methods: In this randomized comparative study, undertaken from January 2021 to August 2022, 60 patients were randomly divided into two groups of 30 each, Group A- Injection Fentanyl (25 mcg) + Ropivacaine (0.375%) in 20ml dilution and Group B- Injection Dexmed (25 mcg) + Ropivacaine (0.375%) in 20 ml dilution were injected in TAP block on either side. The outcome was studied at 3, 6, 9, 12, and 24 hours, postoperatively. Results: The mean duration of analgesia in patient’s of group B was higher and statistically significant (“p-value”<0.001) than group-A. Similarly, pain on Visual Analog Scale (VAS)) in patient’s Group B was less at each stage of follow-up; postoperatively. The drug demand for the desired analgesia in Group B was six times less and without any marked side effects, as compared to Group A. Conclusion: Dexmed   was found to be more effective in providing postoperative analgesia with low drug demand and without any significant side effect, as compared to Fentanyl, as an adjuvant with Ropivacaine, given through TAP blocks.