Role of USG guided transversus abdominis plane block with different adjuvants in enhancing postoperative analgesia in total abdominal hysterectomy

Abdominal hysterectomy is open surgical procedure associated with considerable post operative pain. The use of transverse lower abdominal incisions in hysterectomies and myomectomies often cause severe pain during first 48 hours postoperatively which can adversely impact healing, patient outcomes and prolong the length of hospital stay .More recently multimodal analgesia like tap blocks has been providing better post operative pain relief. Ropivacaine is an amide local anesthetic with better sensory and motor blocking profiles and with low toxicity potential. Dexmedetomidine  is an selective alpha 2 adrenergic agonist with sedative and analgesic properties. Dexamethasone as an adjuvant causes early onset and prolongs the duration of analgesia. Thus in our current study we aim to assess the efficacy of 0.25 ropivacaine and compare it with dexamethasone and dexmedetomidine in USG guided TAP block in providing post operative analgesia.