What is it about?
Adding dexamethasone (4 or 8 mg) to isobaric bupivacaine TAP block reduces postoperative pain,reduces analgesic requirement, and promotes early ambulation in bariatric patients undergoing laparoscopic vertical banded gastroplasty in comparison with isobaric bupivacaine TAP block alone.
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Why is it important?
In the current study, addition 4 or 8 mg dexamethasone as an adjuvant to isobaric bupivacaine TAP block was safe in bariatric patient as there were no recorded cases of episodes of hyperglycemia or uncontrolled hypertension during the study period. In accordance with our study, previous studies reported the safety of a single dose and short-term (<24 h) use of dexamethasone
Perspectives
Th e current study has potential limitations of lacking an active control comparing the eff ect of intravenous and TAP block dexamethasone. Perhaps, intravenous dexamethasone with bupivacaine TAP block would have the same eff ect. In addition, the study lacked along the follow-up period that permits reporting rate postoperative wound infection, which is a concern on using dexamethasone in bariatric patients. Th us, further studies comparing intravenous dexamethasone with bupivacaine TAP block to dexamethasone and bupivacaine TAP block, as well as studies with a longer study period reporting the rate of postoperative wound infection are also recommended.
Dr Hanaa Abd Allah El Gendy
Ain Shams University
Read the Original
This page is a summary of: Ultrasound-guided single injection transversus abdominis plane block of isobaric bupivacaine with or without dexamethasone for bariatric patients undergoing laparoscopic vertical banded gastroplasty: a comparative study of different doses, Ain-Shams Journal of Anaesthesiology, January 2015, Medknow,
DOI: 10.4103/1687-7934.156683.
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