Effect of varying doses of dexmedetomidine added to dexamethasone-enhanced TAPB for post-cesarean pain management.

Background: The management of post-cesarean pain exhibits considerable variation across different regions and hospitals, with a prevalent tendency to utilize opioid medications as the primary analgesic approach. This study investigates the impact of different doses of dexmedetomidine combined with dexamethasone as an adjunct to transversus abdominis plane block (TAPB) on the analgesic efficacy and quality of recovery following cesarean section. Methods: In this prospective randomized clinical trial, 90 patients scheduled for cesarean section were randomly assigned in a 1:1:1 ratio to receive postoperative TAPB with one of three solutions: 8 mg dexamethasone with 0.375% ropivacaine (Group C), 0.5 μg/kg dexmedetomidine with 8 mg dexamethasone and 0.375% ropivacaine (Group D1), or 1 μg/kg dexmedetomidine with 8 mg dexamethasone and 0.375% ropivacaine (Group D2). The primary outcome measures were the VAS scores for rest and movement at 6, 12, 24, and 48 h post TAPB, as well as the incidence of moderate to severe pain. Results: Postoperative VAS scores demonstrated distinct patterns between rest and dynamic pain. At rest, no significant differences were observed among groups C, D1, and D2 at any time point (6-48 h; all Conclusion: Adding dexmedetomidine and dexamethasone to ropivacaine for TAPB can improve post-cesarean section pain conditions. Clinical trial registration: https://clinicaltrials.gov/, ChiCTR2400081531.