Brandon C Chapman1, Brian Shepherd2, Richard Moore3, Daniel J Stanley3, Eric C Nelson3. 1. University of Tennessee College of Medicine Chattanooga, Department of Surgery, Chattanooga, TN, USA. Electronic address: brandon.chapman@cuanschutz.edu. 2. University of Tennessee College of Medicine Chattanooga, Department of Anesthesiology, Chattanooga, TN, USA. 3. University of Tennessee College of Medicine Chattanooga, Department of Surgery, Chattanooga, TN, USA.
Abstract
BACKGROUND: The objective of this study is to determine if the addition of dexmedetomidine to dexamethasone in transversus abdominis plane (TAP) blocks lowers postoperative opioid use following colorectal surgery. METHODS: Retrospective review of patients undergoing minimally invasive colorectal surgery and perioperative TAP block with either 1) local anesthetic and dexamethasone or 2) local anesthetic, dexamethasone, and dexmedetomidine. Post-operative opioid use was converted to morphine milligram equivalents (MME). RESULTS: 55 patients were identified: 38 (69%) receiving dexamethasone only and 17 (31%) receiving dexamethasone and dexmedetomidine. The dexamethasone and dexmedetomidine group had significantly lower median MME use at 12-h (2 vs. 13 mg), 24-h (4 vs. 28 mg), 36-h (8 vs. 38 mg), and 48-h (17 vs. 53 mg) (all p < 0.05). There was no difference at 72-h. CONCLUSION: Perioperative TAP blocks with dexamethasone and dexmedetomidine following colorectal surgery results in significantly less postoperative opioid use up to 48 h after surgery.
BACKGROUND: The objective of this study is to determine if the addition of dexmedetomidine to dexamethasone in transversus abdominis plane (TAP) blocks lowers postoperative opioid use following colorectal surgery. METHODS: Retrospective review of patients undergoing minimally invasive colorectal surgery and perioperative TAP block with either 1) local anesthetic and dexamethasone or 2) local anesthetic, dexamethasone, and dexmedetomidine. Post-operative opioid use was converted to morphine milligram equivalents (MME). RESULTS: 55 patients were identified: 38 (69%) receiving dexamethasone only and 17 (31%) receiving dexamethasone and dexmedetomidine. The dexamethasone and dexmedetomidine group had significantly lower median MME use at 12-h (2 vs. 13 mg), 24-h (4 vs. 28 mg), 36-h (8 vs. 38 mg), and 48-h (17 vs. 53 mg) (all p < 0.05). There was no difference at 72-h. CONCLUSION: Perioperative TAP blocks with dexamethasone and dexmedetomidine following colorectal surgery results in significantly less postoperative opioid use up to 48 h after surgery.
Authors: Amnon A Berger; Zuby Syed; Lianne Ryan; Christopher Lee; Jamal Hasoon; Ivan Urits; Omar Viswanath; Elyse M Cornett; Alan D Kaye; Jonathan P Eskander Journal: Orthop Rev (Pavia) Date: 2022-04-25