Role of Dexamethasone in Transversus Abdominis Plane Block After Cesarean Section

Aswan University Hospital

Status: Completed

Conditions: Cesarean Section

Treatments: Drug: dexamethasone; Drug: placebo to dexamethasone; Drug: bupivacaine

Study type: Interventional

Funder types: Other

Identifiers

NCT03767920

aswu/180/7/18

Details and patient eligibility

About

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.

Full 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.

Enrollment: 120 patients

Sex: Female

Ages: 18 to 45 years old

Volunteers: No Healthy Volunteers

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,

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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120 participants in 2 patient groups

bupivacaine and dexamethasone

Active Comparator group

Description:

Bilateral TAP block with 20 ml of 0.25% bupivacaine + 4 mg/kg dexamethasone diluted with isotonic saline.

Treatment:

Drug: bupivacaine

Drug: dexamethasone

bupivacaine and placebo to dexamethasone

Active Comparator group

Description:

BilateralTAP block with 20 ml of 0.25% bupivacaine bilaterally plus placebo to dexamethasone

Treatment:

Drug: bupivacaine

Drug: placebo to dexamethasone