Post-operative Analgesic Effect of Dexmedetomidine and Dexamethasone as Adjunct in Transversus Abdominis Plane Block During Cesarean Section

ElEtr, Mohammed Fawzy; Omera, Magdy; Ahmed, Nashwa

doi:10.21608/muj.2025.406900.1240

	Post-operative Analgesic Effect of Dexmedetomidine and Dexamethasone as Adjunct in Transversus Abdominis Plane Block During Cesarean Section
Medicine Updates
Articles in Press, Accepted Manuscript, Available Online from 24 August 2025
Document Type: Original Article
DOI: 10.21608/muj.2025.406900.1240
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Authors
Mohammed Fawzy ElEtr ¹; Magdy Omera²; Nashwa Ahmed ²
¹Anesthesia and Surgical Intensive Care
²Anesthesia and Surgical Intensive Care, Faculty of Medicine, Port Said University, Egypt
Abstract
Background: Effective postoperative pain control after cesarean delivery enhances maternal recovery and neonatal care. Ultrasound-guided transversus abdominis plane (TAP) block is a key component of multimodal analgesia. Adjuvants such as dexmedetomidine or dexamethasone may extend block duration. This study compared their analgesic efficacy and safety when combined with bupivacaine in TAP block. Methods: In this randomized controlled trial, 42 women undergoing elective cesarean section under spinal anesthesia at Al-Hayah Port Fouad Hospital were allocated into three equal groups: Control—40 ml 0.25% bupivacaine + saline; DMD—38 ml bupivacaine + dexmedetomidine 100 μg; DEXA—38 ml bupivacaine + dexamethasone 8 mg. Primary outcome: time to first rescue analgesia. Secondary outcomes: postoperative VAS scores, total analgesic consumption, sedation, and adverse events within 24 h. Results: Dexmedetomidine significantly prolonged analgesia, reduced VAS scores during the first 18 h, and lowered total analgesic use compared with dexamethasone (p < 0.001), but caused more transient bradycardia and hypotension. Conclusions: Dexmedetomidine provided superior analgesia but with more hemodynamic effects. Dexamethasone offered slightly shorter analgesia with a safer profile, favoring its use in patients with cardiovascular risk. Keywords: TAP block, spinal anesthesia, cesarean section, adjuvant, bupivacaine, dexmedetomidine,
Keywords
Dexamethasone; Dexmedetomidine; TAP block


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