Effect of varying doses of dexmedetomidine added to dexamethasone-enhanced TAPB for post-cesarean pain management
BackgroundThe management of post-cesarean pain exhibits considerable variation across different regions and hospitals, with a prevalent tendency to utilize opioid medications as the primary analgesic approach. This study investigates the impact of different doses of dexmedetomidine combined with dex...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2025.1593574/full |
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| author | Yang Gu Yang Gu Fan Yang Jiamin Bao Fa Wang Biyun Tian Biyun Tian Hui Sun Ningkang Li Qingshan Ye |
| author_facet | Yang Gu Yang Gu Fan Yang Jiamin Bao Fa Wang Biyun Tian Biyun Tian Hui Sun Ningkang Li Qingshan Ye |
| author_sort | Yang Gu |
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| description | BackgroundThe management of post-cesarean pain exhibits considerable variation across different regions and hospitals, with a prevalent tendency to utilize opioid medications as the primary analgesic approach. This study investigates the impact of different doses of dexmedetomidine combined with dexamethasone as an adjunct to transversus abdominis plane block (TAPB) on the analgesic efficacy and quality of recovery following cesarean section.MethodsIn this prospective randomized clinical trial, 90 patients scheduled for cesarean section were randomly assigned in a 1:1:1 ratio to receive postoperative TAPB with one of three solutions: 8 mg dexamethasone with 0.375% ropivacaine (Group C), 0.5 μg/kg dexmedetomidine with 8 mg dexamethasone and 0.375% ropivacaine (Group D1), or 1 μg/kg dexmedetomidine with 8 mg dexamethasone and 0.375% ropivacaine (Group D2). The primary outcome measures were the VAS scores for rest and movement at 6, 12, 24, and 48 h post TAPB, as well as the incidence of moderate to severe pain.ResultsPostoperative VAS scores demonstrated distinct patterns between rest and dynamic pain. At rest, no significant differences were observed among groups C, D1, and D2 at any time point (6–48 h; all p > 0.05). For dynamic pain, group C exhibited higher median scores than D1 and D2 at 12 h [3.00 (IQR 2.00–4.00) vs. 1.00 (1.00–3.00), median difference 1.00 (95% CI 1.00–2.00); p = 0.001; vs. 2.00 (1.00–3.00), difference 1.00 (0.00–2.00); p = 0.003] and 24 h [4.00 (3.00–4.00) vs. D1: 3.00 (2.00–3.00), difference 1.00 (0.00–1.00); p < 0.001; vs. D2: 2.00 (2.00–3.00), difference 1.00 (1.00–2.00); p = 0.009]. By 48 h, D2 showed the lowest dynamic pain scores [1.00 (1.00–2.00) vs. C: 3.00 (2.00–3.00); difference 1.00 (1.00–1.00); p = 0.001]. Moderate-to-severe dynamic pain incidence differed significantly at 12 h (C: 26.7%; D1: 13.3%; D2: 3.3%; p = 0.04) and peaked in group C at 24 h [53.3% vs. D1: 13.3% (risk ratio 7.43, 95% CI 2.08–26.55; p = 0.002) and D2: 10.0% (risk ratio 10.29, 2.56–41.37; p = 0.001)]. No intergroup differences were observed for resting pain or dynamic pain at 48 h. Groups D1 and D2 showed no significant differences in outcomes at any time point.ConclusionAdding dexmedetomidine and dexamethasone to ropivacaine for TAPB can improve post-cesarean section pain conditions.Clinical trial registrationhttps://clinicaltrials.gov/, ChiCTR2400081531. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj-art-b6f02e1a0de8484d8cc67e0b2393f4882025-08-20T03:58:44ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.15935741593574Effect of varying doses of dexmedetomidine added to dexamethasone-enhanced TAPB for post-cesarean pain managementYang Gu0Yang Gu1Fan Yang2Jiamin Bao3Fa Wang4Biyun Tian5Biyun Tian6Hui Sun7Ningkang Li8Qingshan Ye9Department of Anesthesiology, Ningxia Medical University, Yinchuan, ChinaDepartment of Anesthesiology, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, Ningxia, ChinaDepartment of Anesthesiology, General Hospital of Ningxia Medical University, Yinchuan, ChinaDepartment of Anesthesiology, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, Ningxia, ChinaDepartment of Anesthesiology, Ningxia Medical University, Yinchuan, ChinaDepartment of Anesthesiology, Ningxia Medical University, Yinchuan, ChinaDepartment of Anesthesiology, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, Ningxia, ChinaDepartment of Anesthesiology, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, Ningxia, ChinaDepartment of Anesthesiology, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, Ningxia, ChinaDepartment of Anesthesiology, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, Ningxia, ChinaBackgroundThe management of post-cesarean pain exhibits considerable variation across different regions and hospitals, with a prevalent tendency to utilize opioid medications as the primary analgesic approach. This study investigates the impact of different doses of dexmedetomidine combined with dexamethasone as an adjunct to transversus abdominis plane block (TAPB) on the analgesic efficacy and quality of recovery following cesarean section.MethodsIn this prospective randomized clinical trial, 90 patients scheduled for cesarean section were randomly assigned in a 1:1:1 ratio to receive postoperative TAPB with one of three solutions: 8 mg dexamethasone with 0.375% ropivacaine (Group C), 0.5 μg/kg dexmedetomidine with 8 mg dexamethasone and 0.375% ropivacaine (Group D1), or 1 μg/kg dexmedetomidine with 8 mg dexamethasone and 0.375% ropivacaine (Group D2). The primary outcome measures were the VAS scores for rest and movement at 6, 12, 24, and 48 h post TAPB, as well as the incidence of moderate to severe pain.ResultsPostoperative VAS scores demonstrated distinct patterns between rest and dynamic pain. At rest, no significant differences were observed among groups C, D1, and D2 at any time point (6–48 h; all p > 0.05). For dynamic pain, group C exhibited higher median scores than D1 and D2 at 12 h [3.00 (IQR 2.00–4.00) vs. 1.00 (1.00–3.00), median difference 1.00 (95% CI 1.00–2.00); p = 0.001; vs. 2.00 (1.00–3.00), difference 1.00 (0.00–2.00); p = 0.003] and 24 h [4.00 (3.00–4.00) vs. D1: 3.00 (2.00–3.00), difference 1.00 (0.00–1.00); p < 0.001; vs. D2: 2.00 (2.00–3.00), difference 1.00 (1.00–2.00); p = 0.009]. By 48 h, D2 showed the lowest dynamic pain scores [1.00 (1.00–2.00) vs. C: 3.00 (2.00–3.00); difference 1.00 (1.00–1.00); p = 0.001]. Moderate-to-severe dynamic pain incidence differed significantly at 12 h (C: 26.7%; D1: 13.3%; D2: 3.3%; p = 0.04) and peaked in group C at 24 h [53.3% vs. D1: 13.3% (risk ratio 7.43, 95% CI 2.08–26.55; p = 0.002) and D2: 10.0% (risk ratio 10.29, 2.56–41.37; p = 0.001)]. No intergroup differences were observed for resting pain or dynamic pain at 48 h. Groups D1 and D2 showed no significant differences in outcomes at any time point.ConclusionAdding dexmedetomidine and dexamethasone to ropivacaine for TAPB can improve post-cesarean section pain conditions.Clinical trial registrationhttps://clinicaltrials.gov/, ChiCTR2400081531.https://www.frontiersin.org/articles/10.3389/fmed.2025.1593574/fulldexmedetomidinedexamethasonenerve blockspainpostoperativecesarean sections |
| spellingShingle | Yang Gu Yang Gu Fan Yang Jiamin Bao Fa Wang Biyun Tian Biyun Tian Hui Sun Ningkang Li Qingshan Ye Effect of varying doses of dexmedetomidine added to dexamethasone-enhanced TAPB for post-cesarean pain management Frontiers in Medicine dexmedetomidine dexamethasone nerve blocks pain postoperative cesarean sections |
| title | Effect of varying doses of dexmedetomidine added to dexamethasone-enhanced TAPB for post-cesarean pain management |
| title_full | Effect of varying doses of dexmedetomidine added to dexamethasone-enhanced TAPB for post-cesarean pain management |
| title_fullStr | Effect of varying doses of dexmedetomidine added to dexamethasone-enhanced TAPB for post-cesarean pain management |
| title_full_unstemmed | Effect of varying doses of dexmedetomidine added to dexamethasone-enhanced TAPB for post-cesarean pain management |
| title_short | Effect of varying doses of dexmedetomidine added to dexamethasone-enhanced TAPB for post-cesarean pain management |
| title_sort | effect of varying doses of dexmedetomidine added to dexamethasone enhanced tapb for post cesarean pain management |
| topic | dexmedetomidine dexamethasone nerve blocks pain postoperative cesarean sections |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1593574/full |
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