Ultrasound-guided transversus abdominis plane block using ropivacaine and different doses of perineural dexmedetomidine for analgesia after cesarean section: a randomized controlled clinical trial
Abstract
Background: Dexmedetomidine is frequently combined with ropivacaine in ultrasound-guided transversus abdominis plane (TAP) block for analgesia after cesarean section (CS), but is associated with adverse effects. The ideal dose of dexmedetomidine as local anesthetic adjuvant has not been determined. This study aimed to explore the dose of perineural dexmedetomidine for ensuring analgesic efficacy while minimizing adverse effects.
Methods: Patients undergoing CS under combined spinal-epidural anesthesia were randomly allocated to five groups: DR (0.00 μg/kg dexmedetomidine), DR1 (0.25 μg/kg), DR2 (0.50 μg/kg), DR3 (0.75 μg/kg), and DR4 (1.00 μg/kg), all combined with ropivacaine for TAP block. The co-primary outcomes were time to first rescue analgesia and total consumption of sufentanil at 48 h. The secondary outcomes included visual analogue scale (VAS) scores; Ramsay Sedation Scale scores; patient satisfaction scores; time to first ambulation; length of hospital stay; and postoperative complications. Success was defined as achieving statistical significance for both primary endpoints.
Results: Among 150 enrolled patients, 12 were excluded for protocol violations, leaving 138 participants in the final analysis. With increasing doses of dexmedetomidine, time to first rescue analgesia was significantly prolonged (from 5.42 ± 2.29 h to 11.26 ± 2.48 h; P P P P < 0.001) decreased. No significant differences were observed among the five groups for VAS pain scores (group × time…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 150 participants or records.
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