Dexmedetomidine as an Adjuvant to Ropivacaine in Quadratus Lumborum Block for Patients Undergoing Laparoscopic Inguinal Hernia Repair: A Comparative Randomized Study

Abstract

Background: The Quadratus Lumborum Block (QL2) produces a broad distribution of local anesthesia, resulting in a large area of sensory inhibition from T7 to L1 in most cases. Therefore, QLBs are used to provide postoperative analgesia for abdominopelvic surgeries. Dexmedetomidine, an α₂-adrenergic agonist, possesses sedative, anxiolytic, hypnotic, analgesic, and sympatholytic properties. In this study, we aimed to determine the analgesic efficacy of dexmedetomidine as an adjuvant to ropivacaine in the quadratus lumborum block for patients undergoing laparoscopic inguinal hernia repair.
Methods: A total of 70 patients belonging to ASA grades I and II and aged between 30 and 60 years scheduled for elective laparoscopic inguinal hernia repair were randomly assigned into two groups. Group I received 0.375% plain ropivacaine, and Group II received 0.375% ropivacaine along with 100 mcg of dexmedetomidine after induction of general anesthesia through QL2. The primary outcome was to compare the time to first rescue analgesic between the two groups. Other secondary outcomes observed were VAS for 24 hours postoperatively, total number of rescue analgesia doses, and adverse effects, if any.
Results: Both groups were statistically comparable for demographic variables, ASA physical status grading, and duration of surgery. The time to the first rescue analgesic request was significantly prolonged in Group II compared to Group I (p < 0.001). The mean VAS scores and total rescue analgesic requirements were higher in Group I, indicating superior analgesic efficacy in Group II.
Conclusion: The addition of dexmedetomidine to ropivacaine in a quadratus lumborum block significantly prolonged the duration of analgesia compared with ropivacaine alone.