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Purpose: Different adjuvants have been used to improve the quality and increase the duration of local anesthetics during various nerve block techniques. The aim of the present work is to evaluate the effect of preemptive dexamethasone added to bupivacaine on postoperative pain in patients receiving transversus abdominis plain block (TAPB) guided with ultrasound for inguinal hernia repair as regard the time of the first request for additional analgesia, Pain scores, total analgesic consumption and analgesic efficacy.

Patients and Methods the present study was carried out in the Main Alexandria University Hospital on 50 adult male patients aged 20 to 60 years, American Society of Anesthesiologists (ASA) class I or II. patients were randomly allocated to receive TAP block with ultrasonography in. using 20 mL of bupivacaine hydrochloride 0.5%+ 2 mL saline 0.9%(control group, n= 25) or 20 mL of bupivacaine hydrochloride 0.5%+ 2 mL dexamethasone “8 mg”(dexamethasone group, n= 25). The primary outcome was postoperative pain, as evaluated by visual analog scale (VAS) for pain scoring at 1, 2,, 3, 4,, 12, 16, 20and24 hr postoperatively, whereas the secondary outcomes were time to duration of analgesia, first analgesia (TFA), morphine consumption and the occurrence of nausea, vomiting.