What does this research mean for the field?

Adding dexmedetomidine to intrathecal bupivacaine is more effective than adding neostigmine for reducing postoperative pain intensity in women undergoing elective cesarean section. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study aims to evaluate the effects of dexmedetomidine and neostigmine on pain intensity and sedation in women undergoing elective cesarean section under spinal anesthesia.

May 31, 2026Open Access

Comparing additive effect of dexmedetomidine and neostigmine to bupivacaine on postspinal anesthesia cesarean section induced pain intensity: A health promotion Approach

Key Points

This study aims to evaluate the effects of dexmedetomidine and neostigmine on pain intensity and sedation in women undergoing elective cesarean section under spinal anesthesia.
Conducted a clinical trial on women undergoing elective CS between 2022 and 2023.
Participants received either bupivacaine with dexmedetomidine or bupivacaine with neostigmine and were evaluated at several time points after anesthesia.
Statistical comparisons were made using a generalized estimating equation (GEE) model.
Pain intensity was significantly lower in the dexmedetomidine group compared to the neostigmine group (P < 0.001).
Mean pain intensity score for neostigmine was 0.75, indicating higher pain levels compared to the dexmedetomidine group (P < 0.001).
The study highlights dexmedetomidine's superior pain reduction and sedative effects compared to neostigmine.

Abstract

BACKGROUND: This study pursued the goal to evaluate the effect of dexmedetomidine and neostigmine on pain, sedation, and locomotor properties during and after surgery in the patients receiving intrathecal bupivacaine for spinal anesthesia in women with elective cesarean section (CS) and to assess the effective dose of dexmedetomidine and neostigmine. MATERIALS AND METHODS: The present clinical trial study was performed on the women as the candidates for elective CS between 2022 and 2023 in Imam Khomeini Educational and Medical Center located in Mazandaran province. The patients for spinal anesthesia were divided into two groups: (1) receiving bupivacaine and dexmedetomidine (1 μg) and (2) receiving bupivacaine and neostigmine (10 μg). Bromage, Visual Analog Scale, and Ramsay scores were recorded in each patient at the intervention time, 2, 4, 8, and 12 h after the onset of anesthesia, along with the demographic and clinical baseline characteristics. The generalized statistical estimating model (GEE) was used to compare the variance of the aforementioned criteria between the two groups. The statistical significance level of 0.05 was used, and all statistical analyses were conducted using STATA/MP. 17: Stata|; M Statistical Software: Release 17. College Station, TX: StataCorp LLC. RESULTS: One hundred ten individuals participated in this study. The study participants’ mean age was 31.56 ± 5.92. The level of pain intensity in group 1 was lower than that of group 2, which was statistically significant ( P < .001). In the GEE and after controlling the effects of the variables including age, body mass index and mean arterial blood pressure, it was found that the mean score of pain intensity score in group 2 was 0.75 (the confidence limits 0.59 equal to 0.59–0.91), which was more than that of group 1 ( P < .001). CONCLUSION: Using dexmedetomidine exerts a greater and better effect on reducing pain intensity and boosts the sedative effect of neostigmine in the patients undergoing CS. It is suggested to run a study with a larger statistical community to deal with this issue. The results of this study can be useful in making prevention decisions and maintaining performance of women.

Comparing additive effect of dexmedetomidine and neostigmine to bupivacaine on postspinal anesthesia cesarean section induced pain intensity: A health promotion Approach

Key Points

Abstract

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