Effectiveness of Intravenous Single-Dose Magnesium Sulphate Versus Dexamethasone as an Adjuvant to Ultrasound-Guided Transversus Abdominis Plane Block for Control of Post-Cesarean Analgesia
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 80
- 主要终点
- Duration of analgesia
研究概览
简要总结
This randomized, double-blind, controlled clinical trial will compare the effectiveness of a single intravenous dose of magnesium sulphate versus dexamethasone as an adjuvant to ultrasound-guided transversus abdominis plane (TAP) block for postoperative pain management after elective cesarean section. Eighty women undergoing elective lower-segment cesarean section under spinal anesthesia will be randomly allocated into two groups of 40 participants each. Group M will receive intravenous magnesium sulphate 50 mg/kg diluted in 100 mL normal saline, while Group D will receive intravenous dexamethasone 8 mg diluted in 100 mL normal saline. The study will assess postoperative pain using the Visual Analog Scale at 2, 4, 8, 12, and 24 hours after surgery, as well as duration of analgesia, rescue analgesic requirement, total tramadol consumption, and adverse effects. The study aims to determine whether either intravenous adjuvant provides more effective and prolonged postoperative analgesia when used with ultrasound-guided TAP block after cesarean section.
详细描述
Post-cesarean pain can affect maternal comfort, mobility, breastfeeding and postoperative recovery. Effective postoperative analgesia is therefore an important component of care following cesarean section. Ultrasound-guided transversus abdominis plane (TAP) block is used as part of multimodal analgesia to provide abdominal wall somatic analgesia and may reduce the requirement for systemic opioid analgesics.
This study will evaluate whether the addition of a single intravenous dose of magnesium sulphate or dexamethasone provides better postoperative analgesia when used as an adjunct to ultrasound-guided TAP block in women undergoing elective cesarean section.
The study will be conducted as a randomized, double-blind, controlled clinical trial in the Department of Anesthesia, Khyber Teaching Hospital, Peshawar. A total of 80 women will be included, with 40 participants allocated to the magnesium sulphate group (Group M) and 40 participants allocated to the dexamethasone group (Group D).
Eligible participants will be women aged 18-40 years undergoing elective lower-segment cesarean section under spinal anesthesia, with ASA physical status I or II, singleton full-term pregnancy of at least 37 weeks, and willingness to provide written informed consent.
Participants with known allergy or contraindication to magnesium sulphate, dexamethasone or local anesthetics; chronic pain disorders or regular analgesic/opioid use; neurological, renal, hepatic or cardiovascular disease; pregnancy complications such as pre-eclampsia, eclampsia or placenta previa; conversion to general anesthesia; inadequate spinal anesthesia or failed TAP block; or refusal to participate will be excluded.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
盲法说明
Participants, care providers, investigators, and outcomes assessors will be blinded to treatment allocation. Participants will be randomly assigned to receive either intravenous magnesium sulphate or intravenous dexamethasone. The study interventions will be prepared and administered according to the study protocol to maintain blinding. Postoperative outcome assessments and data collection will be performed by qualified anesthesiology residents blinded to group allocation.
入排标准
- 年龄范围
- 18 Years 至 40 Years（Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Women aged 18-40 years.
- •Undergoing elective lower-segment cesarean section under spinal anesthesia.
- •American Society of Anesthesiologists (ASA) physical status I or II.
- •Singleton, full-term pregnancy with gestational age of at least 37 weeks.
- •Willing to provide written informed consent.
排除标准
- •Known allergy or contraindication to magnesium sulphate, dexamethasone, or local anesthetics.
- •History of chronic pain disorders or regular use of analgesics or opioids.
- •Neurological, renal, hepatic, or cardiovascular disease.
- •Pregnancy complications such as pre-eclampsia, eclampsia, or placenta previa.
- •Intraoperative conversion to general anesthesia.
- •Inadequate spinal block or failed TAP block.
- •Refusal to participate in the study.
结局指标
主要结局
Duration of analgesia
时间窗: From completion of the TAP block until the first request for rescue analgesia, assessed during the first 24 hours after cesarean section.
Time from administration of the ultrasound-guided TAP block until the participant's first request for rescue analgesia, measured in minutes.
次要结局
未报告次要终点
研究者
Maleeha Rahman
Trainee medical officer
Khyber Teaching Hospital