Caesarean Section, Dexmedetomidine, Postoperative Analgesia, Quadratus Lumborum Block
Conditions
Keywords
dexmedetomidine, Quadratus lumborum block, caesarean section
Brief summary
The goal of this clinical trial is to evaluate the effects of adding Dexmedetomidine to local anesthetic agent (bupivacaine) for quadratus lumborum block (QLB) after spinal anesthesia in patient undergoing elective caesarean section. The main questions it aims to answer are: 1. does adding dexmedetomidine enhance analgesia time? 2. does adding dexmedetomidine reduce recovery time? 3. does adding dexmedetomidine lower the need of analgesic medication after surgery? Study include 80 female pregnant non-obese patients scheduled for elective caesarean section.
Detailed description
Effective postoperative analgesia facilitates a mother's quick recovery, enhances early ambulation, promotes breastfeeding, and reduces the risk of postoperative thromboembolism. The aim of this study was to evaluate the postoperative analgesic efficacy of combining a local anesthetic with dexmedetomidine (DEX) in a quadratus lumborum block (QLB) following a cesarean section (CS). A prospective, randomized, blind, controlled trial included 80 female patients aged 18 - 40 years old who underwent cesarean delivery under spinal anesthesia, were randomly assigned to two equal groups. Group dB received a quadratus lumborum block (QLB) with 20 ml of 0.25% bupivacaine and dexmedetomidine (0.5 μg/kg) on each side, while Group B received QLB with 20 ml of 0.25% bupivacaine alone on each side. The primary outcome measured was total analgesic consumption over 24 hours postoperatively. Secondary outcomes included Visual Analog Scale (VAS) scores, time to first analgesic request, and the incidence of side effects such as sedation, nausea, vomiting, shivering, pruritus, bradycardia, hypotension, and respiratory depression.
Interventions
DRUGDexmedetomidine
Studying combining a local anesthetic with dexmedetomidine (DEX) in a quadratus lumborum block (QLB) following a cesarean section (CS) in elective surgery in Bint Al-Huda Hospital.
Sponsors
Majid Fakhir Mutar Alhamaaidah
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 40 Years
Healthy volunteers
Yes
Inclusion criteria
* Age over 18 years' old and less 40 years. * With body mass indices (BMI) between 18.5 and 34.9 kg/m² * Pregnancy more than 37 weeks with single fetus. * Intact membranes. * Women with a singleton pregnancy.
Exclusion criteria
* ASA class III or higher, * contraindications to spinal anesthesia, * mental or neurological disorders, * chronic heart, renal, or liver diseases, * emergency surgery, * a history of blood coagulation disorders, * allergies or contraindications to the study drugs,
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcome measured was the postoperative pain level score. The Visual Analog Scale (VAS) was used for assessment, where 0 represented no pain and 10 represented the worst pain. | The first 24 hours postoperatively |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The total analgesic consumption | Over the first 24 hours postoperatively | — |
| Sedation levels | At 2, 4, 6, 12, and 24 hours postoperatively | Sedation levels were also monitored using the Ramsay Sedation Scale which helps assess the patient's level of sedation and consciousness; was used to assess postoperative sedation at 2, 4, 6, 12, and 24 hours postoperatively |
| The time to the first analgesic request (within the first 24 hours postoperatively ) | over the first 24 hours postoperatively | — |
| Mean Blood Pressure (MBP) | Perioperative period at intervals of 0, 5, 10, 20, and 30 minutes | Measured in mmHg |
| Heart Rate (HR) | Perioperative period at intervals of 0, 5, 10, 20, and 30 minutes | Measured as beats/minute |
| Postoperative nausea and vomiting (PONV) | Within the first 24 hours | — |
Countries
Iraq
Outcome results
None listed