Dual adjunct therapy with dexamethasone and dexmedetomidine in transverse abdominus plane blocks reduces postoperative opioid use in colorectal surgery

Abstract Background The objective of this study is to determine if the addition of dexmedetomidine to dexamethasone in transversus abdominus 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 group. 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  Conclusion Perioperative TAP blocks with dexamethasone and dexmedetomidine following colorectal surgery results in significantly less postoperative opioid use up to 48 h after surgery.