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The goal of this clinical trial is to evaluate the effects of adding Dexmedetomidine to local anesthetic agent (bupivacaine) for quadratus lumborum block (QLB) after spinal anesthesia in patient undergoing elective caesarean section. The main questions it aims to answer are:
Effective postoperative analgesia facilitates a mother's quick recovery, enhances early ambulation, promotes breastfeeding, and reduces the risk of postoperative thromboembolism. The aim of this study was to evaluate the postoperative analgesic efficacy of combining a local anesthetic with dexmedetomidine (DEX) in a quadratus lumborum block (QLB) following a cesarean section (CS). A prospective, randomized, blind, controlled trial included 80 female patients aged 18 - 40 years old who underwent cesarean delivery under spinal anesthesia, were randomly assigned to two equal groups. Group dB received a quadratus lumborum block (QLB) with 20 ml of 0.25% bupivacaine and dexmedetomidine (0.5 μg/kg) on each side, while Group B received QLB with 20 ml of 0.25% bupivacaine alone on each side. The primary outcome measured was total analgesic consumption over 24 hours postoperatively. Secondary outcomes included Visual Analog Scale (VAS) scores, time to first analgesic request, and the incidence of side effects such as sedation, nausea, vomiting, shivering, pruritus, bradycardia, hypotension, and respiratory depression.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group dB | Active Comparator | Adding Dexmedetomidine |
|
| Group B | No Intervention | Only bupivacaine |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dexmedetomidine | Drug | Studying combining a local anesthetic with dexmedetomidine (DEX) in a quadratus lumborum block (QLB) following a cesarean section (CS) in elective surgery in Bint Al-Huda Hospital. |
| Measure | Description | Time Frame |
|---|---|---|
| The primary outcome measured was the postoperative pain level score. The Visual Analog Scale (VAS) was used for assessment, where 0 represented no pain and 10 represented the worst pain. | The first 24 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| The time to the first analgesic request (within the first 24 hours postoperatively ) | over the first 24 hours postoperatively | |
| The total analgesic consumption | Over the first 24 hours postoperatively |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Bint Al-Huda Hospital/ thi qar office directorate | Nasiriyah | Thi Qar | 64001 | Iraq |
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| Sedation levels | Sedation levels were also monitored using the Ramsay Sedation Scale which helps assess the patient's level of sedation and consciousness; was used to assess postoperative sedation at 2, 4, 6, 12, and 24 hours postoperatively | At 2, 4, 6, 12, and 24 hours postoperatively |
| Postoperative nausea and vomiting (PONV) | Within the first 24 hours |
| Mean Blood Pressure (MBP) | Measured in mmHg | Perioperative period at intervals of 0, 5, 10, 20, and 30 minutes |
| Heart Rate (HR) | Measured as beats/minute | Perioperative period at intervals of 0, 5, 10, 20, and 30 minutes |
| ID | Term |
|---|---|
| D020927 | Dexmedetomidine |
| ID | Term |
|---|---|
| D007093 | Imidazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
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