Comparing Analgesic Efficacy: Ropivacaine with Dexamethasone vs. Ropivacaine with Dexmedetomidine After Cesarean Section Using Transversus Abdominis Plane Block (2020 - 2021).
{"title":"Comparing Analgesic Efficacy: Ropivacaine with Dexamethasone vs. Ropivacaine with Dexmedetomidine After Cesarean Section Using Transversus Abdominis Plane Block (2020 - 2021).","authors":"Mohammadreza Jamshidi, Mona Ghaderi, Mitra Hojatansari","doi":"10.5812/aapm-147872","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>There are several methods for managing postpartum pain. The combined use of drugs with anesthetics can lead to effective pain management.</p><p><strong>Objectives: </strong>The present study aimed to compare the analgesic effects of ropivacaine (RPV) + dexamethasone (DEXA) and RPV + dexmedetomidine (DEX) on pain after cesarean section (CS) using the transversus abdominis plane (TAP) block.</p><p><strong>Methods: </strong>This double-blind, randomized clinical trial employed a quadruple block randomization method and included 40 participants scheduled for CS at Ayatollah Mousavi Hospital in Zanjan, Iran, during 2020 - 2021. The participants were divided into two groups: The first group received 15 mL of RPV 2% combined with 100 µg of DEX via the bilateral TAP block method, while the second group received 15 ml of RPV 2% combined with 8 mg of DEXA. The analgesic effects of the two drug combinations were evaluated at 0, 3-, 6-, 12-, and 24-hours post-CS using the visual analog scale (VAS) to measure pain intensity. Data analysis was conducted using SPSS software, version 24.</p><p><strong>Results: </strong>In the RPV + DEX group, the onset of pain was delayed, resulting in a longer duration before the administration of painkillers (P = 0.041 and P < 0.001). However, pain intensity between 3- and 24-hours post-surgery was significantly higher in the RPV + DEX group compared to the RPV + DEXA group (P = 0.028, P < 0.001). The RPV + DEX group experienced longer durations before the onset of pain and the need for painkillers (P = 0.041, P < 0.001). Hypotension was more frequently observed in the RPV + DEXA group at 0 hours (P = 0.068) and 3 hours post-surgery (P = 0.003). Additionally, bradycardia and sedation incidences were higher in the RPV + DEXA group at 3 hours post-surgery (P = 0.005, P = 0.048).</p><p><strong>Conclusions: </strong>The use of RPV + DEXA, unlike RPV + DEX, demonstrated positive and significant effects on pain management in female CS candidates using the TAP block method, despite its side effects.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"14 5","pages":"e147872"},"PeriodicalIF":0.0000,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895784/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anesthesiology and Pain Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5812/aapm-147872","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Background: There are several methods for managing postpartum pain. The combined use of drugs with anesthetics can lead to effective pain management.
Objectives: The present study aimed to compare the analgesic effects of ropivacaine (RPV) + dexamethasone (DEXA) and RPV + dexmedetomidine (DEX) on pain after cesarean section (CS) using the transversus abdominis plane (TAP) block.
Methods: This double-blind, randomized clinical trial employed a quadruple block randomization method and included 40 participants scheduled for CS at Ayatollah Mousavi Hospital in Zanjan, Iran, during 2020 - 2021. The participants were divided into two groups: The first group received 15 mL of RPV 2% combined with 100 µg of DEX via the bilateral TAP block method, while the second group received 15 ml of RPV 2% combined with 8 mg of DEXA. The analgesic effects of the two drug combinations were evaluated at 0, 3-, 6-, 12-, and 24-hours post-CS using the visual analog scale (VAS) to measure pain intensity. Data analysis was conducted using SPSS software, version 24.
Results: In the RPV + DEX group, the onset of pain was delayed, resulting in a longer duration before the administration of painkillers (P = 0.041 and P < 0.001). However, pain intensity between 3- and 24-hours post-surgery was significantly higher in the RPV + DEX group compared to the RPV + DEXA group (P = 0.028, P < 0.001). The RPV + DEX group experienced longer durations before the onset of pain and the need for painkillers (P = 0.041, P < 0.001). Hypotension was more frequently observed in the RPV + DEXA group at 0 hours (P = 0.068) and 3 hours post-surgery (P = 0.003). Additionally, bradycardia and sedation incidences were higher in the RPV + DEXA group at 3 hours post-surgery (P = 0.005, P = 0.048).
Conclusions: The use of RPV + DEXA, unlike RPV + DEX, demonstrated positive and significant effects on pain management in female CS candidates using the TAP block method, despite its side effects.