A randomized clinical comparative trial to study the efficacy of adding Clonidine or Dexamethasone to Bupivacaine(0.5%) in prolonging the duration of post operative analgesia with ultrasound guided TAP block in cesarean delivery

With dramatic rise in the rate of cesarean deliveries in the last two decades, post-operative pain management of these patients has become a major medical challenge. We studied the efficacy of adding dexamethasone and Clonidine as adjuvants to bupivacaine using USG guided TAP block.

60 patients posted for elective cesarean delivery under spinal anesthesia were selected for the study. Patients received 20ml of 0.125% Bupivacaine with Dexamethasone (4mg), Clonidine(25μg), Saline(2ml) on each side, in groups D, C and B respectively. Post-operatively pain scores using VAS score, time to first rescue analgesic, and 48hr analgesic consumption were studied.

VAS scores were comparable in all the three groups in the first 12hr, it was higher in group B in the next 36hrs. Time to first resque analgesic was prolonged by 2hrs in all three groups. Tramadol requirement was significantly lower in the group C and group D after 12hrs.

We conclude that USG guided TAP block using either clonidine or dexamethasone as adjuvants to bupivacaine will equally help in alleviating the somatic pain for extended period of time thereby providing substantial improvement in quality of pain care and breast feeding experiences.