Ultrasound guided tap block for cesarean section comparative study of dexamethasone and magnesium sulfate as ropivacaine adjuvants

Abstract

ABSTRACT newlineBackground: newlinePostoperative pain from lower segment cesarean section (LSCS) can hinder nursing, newlineambulation, and maternal bonding. After LSCS, somatic pain comes from surgical newlinewound nociceptors and visceral pain from muscles. Dexamethasone and Magnesium newlinesulphate were tested with Ropivacaine (0.25%) in TAP block for pain management in newlinelower segment cesarean sections under subarachnoid block. newlineMethods: newlineThis study included 72 patients who were equally divided into two groups (36 in each newlinegroup, assigned by computer generated randomization code). newlineGroup RD (n=36): Subjectswere given bilateral US guided TAP Block with newlineRopivacaine 0.25% with Dexamethasone (8mg) 20 ml on each side. newlineGroup RM (n=36): Subjectswere given bilateral USguided TAP Block with newlineRopivacaine 0.25% with Magnesium sulphate (1gram) 20ml on each side. newlineThis study examined the need for first rescue analgesia (RA), pain scores, and postsurgery newlineside effects. The study also ensured a balanced demographic and clinical profile newlineacross both groups to maintain the internal validity of the outcomes. newlineResults: newlineThe average period for first RA was significant between the two groups. The time for newlinefirst RA was significantly longer in group RM (7.29 ± 1.88 hours) than group RD (6.54 newline± 2.19 hours). Both groups demonstrated nil side effects indicating the safety of both newlineadjuvants when used under calculated dosage. The results of studysupport s magnesium newlinesulphate as a better adjuvant compared to dexamethasone for enhancing the analgesic newlineefficacy of ropivacaine in cesarean section patients. Additionally, the study confirmed newlinethat demographic and clinical characteristics did not influence the outcomes, newlineunderscoring the effect was solely attributable to the pharmacological action of the newlineadjuvants. newlineConclusion: newlineThis study emphasizessignficance of selecting appropriate adjuvant medications for newlineachieving postoperative pain in cesarean section subjects. Dexamethasone, with its newlinepotent anti-inflammatory and pain-modulating properties, demonstrated a lesser newlineadvantage over magnesium sulphate in terms of reducing the need for additional newlineanalgesia and maintaining more stable hemodynamic parameters. Future studies are newlineencouraged to explore long-term outcomes and the potential systemic effects of these newlineadjuvants to further refine pain management protocols in surgical settings. This newlineresearch contributes valuable data to the ongoing efforts to optimize postoperative pain newlinemanagement and enhance recovery protocols in obstetric surgery, ultimately aiming to newlineimprove patient outcomes and satisfaction. newlineKeywords: Dexamethasone, Magnesium Sulphate, Ropivacaine, Postoperative pain newlinemanagement, Subarachnoid Block, Visual analogue score