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This study aims to compare the analgesic efficacy of the transversalis fascia plane (TFP) block and intrathecal dexmedetomidine in patients undergoing cesarean section (CS).
Cesarean section (CS) is a commonly performed major surgical procedure that results in substantial postoperative pain and patient dissatisfaction.
Spinal anesthesia is commonly used in CS surgery. However, it may be associated with several side effects, particularly hypotension.
Dexmedetomidine is an α2 adrenergic receptor agonist that has an analgesic effect.
Ultrasound-guided interfascial plane blocks are often used in multimodal analgesia regimens. Local anaesthetic injection into the transversalis fascia plane (TFP) anesthetizes the proximal branches of T12 and L1 which targeted in the plane between the transversus abdominis muscle and the transversalis fascia.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TFP group | Experimental | Patients will receive spinal anesthesia (using 2.5 mL of hyperbaric bupivacaine 0.5%) with bilateral transversalis fascia plane (TFP) block (using 20 mL of bupivacaine 0.25%) at the end of surgery. |
|
| Control group | Active Comparator | Patients will receive spinal anesthesia (using 2.5 mL of hyperbaric bupivacaine 0.5%) + (5 µg intrathecal dexmedetomidine diluted in 0.5ml saline) with a sham block at the end of surgery. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Transversalis fascia plane block | Other | Patients will receive spinal anesthesia (using 2.5 mL of hyperbaric bupivacaine 0.5%) with bilateral transversalis fascia plane (TFP) block (using 20 mL of bupivacaine 0.25%) at the end of surgery. |
| Measure | Description | Time Frame |
|---|---|---|
| Degree of pain | Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS) score. NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). NRS will be assessed at post-anesthesia care unit (PACU), 2, 4, 6, 8, 12, 18 and 24 h postoperatively. | 24 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Total morphine consumption | Rescue analgesia of morphine will be given as 3 mg bolus if the numeric rating scale (NRS) > 3 to be repeated after 30 min if pain persists until the NRS < 4. | 24 hours postoperatively |
| Time to the 1st rescue analgesia |
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Inclusion Criteria:
Exclusion Criteria:
Women undergoing cesarean section
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mohammed S ElSharkawy, MD | Contact | 00201148207870 | mselsharkawy@med.tanta.edu.eg |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tanta University | Recruiting | Tanta | El-Gharbia | 31527 | Egypt |
The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
After the end of study for one year.
The data will be available upon a reasonable request from the corresponding author.
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| Intrathecal dexmedetomidine | Drug | Patients will receive spinal anesthesia (using 2.5 mL of hyperbaric bupivacaine 0.5%) + (5 µg intrathecal dexmedetomidine diluted in 0.5ml saline) with a sham block at the end of surgery. |
|
Time to the first request for the rescue analgesia will be recorded from the end of surgery to first dose of morphine administrated.
| 24 hours postoperatively |
| Mean arterial pressure | Mean arterial pressure will be recorded preoperatively and every 30 minutes till the end of surgery. | Till the end of surgery (Up to 2 hours) |
| Heart rate | Heart rate will be recorded preoperatively and every 30 minutes till the end of surgery. | Till the end of surgery (Up to 2 hours) |
| Incidence of adverse events | Incidence of adverse events such as bradycardia, hypotension, nausea, vomiting, respiratory depression, or any other complication will be recorded. | 24 hours postoperatively |