Effects of Adding Transversus Abdominis Plane Block on Intravenous Nalbuphine and Dexmedetomidine for Severely Pre-Eclamptic Parturients After Cesarean Delivery.

The use of opioids is frequently associated with the occurrence of adverse effects during cesarean delivery, especially for primiparous women with severe preeclampsia, creating a critical need for investigation of alternative analgesic strategies. The study aims to determine the effects of adding transversus abdominis plane block (TAPB) on patient-controlled intravenous analgesia (PCIA) of nalbuphine (Nal) and dexmedetomidine (Dex) on severely pre-eclamptic parturients after cesarean delivery. This is a randomized controlled trial. Severely pre-eclamptic parturients who were scheduled for elective cesarean delivery with spinal anesthesia were randomly assigned into the TAPB group (TAPB combined with PCIA with Nal and Dex; n = 49) and the PCIA group (same block procedures with normal saline followed by PCIA with Nal and Dex; n = 51). Results showed that adding TAPB to PCIA with Nal and Dex significantly lowered visual analog scale (VAS) scores at rest at 2 and 6 h, at mobilization at 2, 6, and 12 h after surgery, reduced press time of PCIA, shortened time for first feeding and out-of-bed movement, enhanced maternal satisfaction with pain control, and lowered plasma levels of cortisone and norepinephrine. The findings of the study suggest that adding TAPB to PCIA with Nal and Dex could enhance acute recovery with fewer stress responses for severely pre-eclamptic parturients after cesarean delivery.