Postoperative Analgesic Outcomes After Bilateral Ultrasound-Guided Transversalis Fascia Plane Block With or Without Dexamethasone in Cesarean Delivery: A Retrospective Cohort Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 93
- 试验地点
- 2
- 主要终点
- Cumulative opioid consumption during the first 24 postoperative hours
研究概览
简要总结
Cesarean delivery is one of the most frequently performed surgical procedures worldwide, and effective postoperative pain management is essential to facilitate early mobilization, maternal-infant bonding, breastfeeding, and overall recovery. Ultrasound-guided transversalis fascia plane block (TFPB) has become an increasingly utilized component of multimodal analgesia following cesarean delivery because it provides effective somatic analgesia of the lower anterior abdominal wall. Adjuvants such as dexamethasone are frequently added to local anesthetics with the aim of prolonging block duration and improving postoperative analgesia; however, evidence regarding the clinical benefits of dexamethasone as an adjunct in TFPB remains limited.
At our institution, bilateral ultrasound-guided TFPB is routinely performed for postoperative analgesia in patients undergoing cesarean delivery under spinal anesthesia, provided there is no contraindication and informed consent has been obtained. According to the treating anesthesiologist's routine clinical preference, dexamethasone may be added to the local anesthetic solution in some patients, whereas others receive local anesthetic alone. This retrospective cohort study will review the medical records and postoperative follow-up forms of patients who underwent cesarean delivery between November 1, 2025, and June 30, 2026. Postoperative analgesic outcomes, including opioid consumption, pain scores, time to first analgesic request, postoperative nausea and vomiting, recovery quality, and block-related adverse events, will be compared between patients receiving bilateral TFPB with dexamethasone and those receiving bilateral TFPB without dexamethasone. The findings are expected to provide real-world evidence regarding the potential contribution of dexamethasone to the analgesic efficacy of bilateral TFPB following cesarean delivery.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 50 Years（Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Female patients aged 18-50 years.
- •Elective cesarean delivery performed under spinal anesthesia.
- •Bilateral ultrasound-guided transversalis fascia plane block performed for postoperative analgesia.
- •Availability of complete perioperative and postoperative follow-up records.
排除标准
- •Emergency cesarean delivery.
- •General anesthesia or combined spinal-epidural anesthesia.
- •Contraindication to transversalis fascia plane block.
- •Chronic opioid use.
- •Allergy to bupivacaine or dexamethasone.
- •Missing or incomplete postoperative follow-up data.
研究组 & 干预措施
TFPB + Dexamethasone
Patients who received bilateral ultrasound-guided transversalis fascia plane block with 25 mL of 0.25% bupivacaine per side plus 8 mg dexamethasone for postoperative analgesia following cesarean delivery under spinal anesthesia.
TFPB Alone
Patients who received bilateral ultrasound-guided transversalis fascia plane block with 25 mL of 0.25% bupivacaine per side for postoperative analgesia following cesarean delivery under spinal anesthesia.
结局指标
主要结局
Cumulative opioid consumption during the first 24 postoperative hours
时间窗: First 24 hours after surgery
Total opioid consumption delivered through the patient-controlled analgesia device during the first 24 hours after surgery, expressed in mg. Patients were instructed to use the PCA device when the Numeric Rating Scale pain score was 4 or higher.
次要结局
- Postoperative pain intensity(1, 3, 6, 9, 12, 18, and 24 hours after surgery)
- Time to first analgesic request(Within the first 24 postoperative hours)
- Quality of postoperative recovery(24 hours after surgery)
研究者
Selma Basyigit
Assistant Professor in anesthesiology
Bahçeşehir University