Cesarean Section
Conditions
Keywords
dexamethasone, transversus abdominis plane block, cesarean section
Brief summary
Our aim to study the efficacy of bupivacaine 0.25% with dexamethasone and that of bupivacaine 0.25% alone in transversus abdominis plane (TAP) block for postoperative analgesia in patients undergoing an elective Caesarean section. * Group 1: bupivacaine 0.25% + dexamethasone 8 mg * Group 2: bupivacaine 0.25% A prospective Randomized Interventional double-blind study.
Detailed description
The pain and discomfort following cesarean delivery are mostly due to the abdominal wall incision and dissection of muscles; it delays early ambulation and breastfeeding. This can lead to postoperative complications such as thromboembolic disorders. So, providing an effective and safe postoperative analgesic method seems to be mandatory. Opioid analgesia remains the most effective means of relieving pain in a wide variety of conditions; however, it may cause adverse effects such as nausea, vomiting, pruritus, urinary retention, and respiratory depression. As the analgesia and the side effects of opioids are dose-dependent, a multimodal approach may enhance analgesia, which in turn would decrease the side effects . Mc Donnell and colleagues have reported that a transversus abdominis plane (TAP) block can decrease the postoperative pain following abdominal surgery. The landmarks of this block were first described in 2001 by Rafi. The TAP block has been performed for postoperative analgesic control in patients undergoing radical prostatectomy, hysterectomy, cesarean delivery under spinal anesthesia, and laparoscopic surgery.
Interventions
DRUGbupivacaine
TAP block with 20 ml of 0.25% bupivacaine bilaterally
DRUGdexamethasone
TAP block with 4 mg dexamethasone bilaterally
TAP block with 4 mg placebo to dexamethasone bilaterally
Sponsors
Aswan University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Masking description
Participating patients, surgeons, anesthesiologists and medical investigators who will be involved in the data collection will be all blinded to the patient's group assignment until the collection of data for all cases will be complete.
Intervention model description
A prospective Randomized Interventional double-blind study.
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* healthy parturient (ASA I and II) scheduled to undergo LSCS under spinal anesthesia
Exclusion criteria
* Participants had known sensitivity to bupivacaine * patient refusal, * localized infection over injection point * patients with significant coagulopathies and * with contraindications to regional anesthesia, * patients with heart diseases, altered renal or liver functions, * psychological disorders, patients with pregnancy-induced hypertension and * gestational diabetes, chronic use of pain medications,
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual analog score for pain during movement | 6 hours post operative | movement-evoked pain measurements ranging from 0 to 10, where 0 no pain and 10 maximum pain |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Visual analog score during rest | 48 hours postoperative | ranging from 0 to 10, where 0 no pain and 10 maximum pain |
| number of patients need Fentanyl consumption | 48 hours postoperative | number of patients need Fentanyl consumption |
| number of days patients stay in hospital | 4 weeks | calculation of number of days patients stay in hospital |
Countries
Egypt
Outcome results
None listed