Vol. 7, Issue 2, Part A (2025)

Postoperative pain following abdominal hysterectomy is often significant, impacting physiological and psychological well-being. Transversus abdominis plane (TAP) block enhanced with adjuvants can improve analgesic duration and quality. This study compares buprenorphine versus dexmedetomidine as adjuvants to ropivacaine in ultrasound-guided TAP blocks for postoperative pain control. In this prospective double-blind randomized controlled trial at Dr. Jeyasekharan Hospital (Nagercoil, Tamil Nadu), 62 ASA I-II women aged 30-60 years scheduled for elective abdominal hysterectomy under spinal anaesthesia were randomized into two groups (n=31 each): Group B received ropivacaine 0.2% with 150 µg buprenorphine; Group D received ropivacaine 0.2% with 25 µg dexmedetomidine. TAP blocks were administered bilaterally under ultrasound guidance post-surgery. Pain (VAS), haemodynamics, and rescue tramadol use were monitored over 24 hours. Data analysis employed independent t-tests/Mann-Whitney U tests and chi-square tests; p<0.05 was statistically significant. Buprenorphine significantly prolonged analgesia duration, yielded lower postoperative pain scores, and reduced total rescue analgesia consumption compared to dexmedetomidine. Hemodynamic parameters remained stable and comparable across both groups. Buprenorphine as an adjuvant in TAP block following abdominal hysterectomy offers superior postoperative analgesia both in duration and quality over dexmedetomidine at the doses studied. Dexmedetomidine’s efficacy appears dose-dependent, and future research should explore optimal dosing to enhance its analgesic profile while minimizing side effects.