Key result
Adding dexmedetomidine to bupivacaine in quadratus lumborum block after cesarean section significantly decreased postoperative morphine use, with bradycardia in 3 patients and hypotension in 2.
Why the study?
Effective postoperative analgesia promotes recovery after cesarean section, but the analgesic efficacy of adding dexmedetomidine to local anesthesia in quadratus lumborum block needed evaluation.
Does adding dexmedetomidine to bupivacaine in quadratus lumborum block reduce postoperative morphine consumption and pain in patients undergoing cesarean section?
RCT (n=50)
Double-blind
randomized
Does adding dexmedetomidine to bupivacaine in quadratus lumborum block reduce postoperative morphine consumption and pain in patients undergoing cesarean section?
Adding dexmedetomidine to bupivacaine in quadratus lumborum block after cesarean section prolongs analgesia and reduces postoperative opioid consumption.
Supports dexmedetomidine adjunct in QL block post-cesarean; extends RCT evidence for opioid-sparing truncal analgesia.
Background Effective analgesia following surgery promotes the delivery mother’s rapid recovery, improves early ambulation, promotes nursing, and lowers the risk of postoperative thromboembolism. The purpose of this work was to assess the postoperative analgesic efficiency of mixing local anesthetic with dexmedetomidine (DEX) in quadratus lumborum block (QLB) after a cesarean section (CS).Methods 50 patients who underwent a cesarean delivery under spinal anesthesia with an average body mass index (BMI) ranging from 18.5 to 34.9 Kg/m2 participated in this double-blinded randomized-controlled study. Two equally sized groups of patients were formed: Group B got QLB with 20 ml of 0. 25% bupivacaine on both sides in addition to DEX 0.5 μg/kg, while group A received QLB with 20 ml of 0.25% bupivacaine in each side alone.Results The total amount of morphine used in the initial 24 hours after surgery and the number of patients who require morphine at 8, twelve, and 24 hours later were substantially decreased in group B than in group A. There was a significant decrease in time to first ambulation and in the Numerical Rating Scale (NRS) after four hours postoperatively in group B than in group A. In group B, three individuals experienced bradycardia, and two patients experienced hypotension as DEX-related side effects.Conclusions The period of postoperative analgesia is prolonged, and the administration of opiates after surgery is decreased when DEX is added to local anesthetics in QLB.
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El‐Sakka et al. (2023) conducted an RCT in Cesarean section (n=50). Dexmedetomidine added to bupivacaine in quadratus lumborum block vs. 20 ml of 0.25% bupivacaine bilaterally alone was evaluated on Total amount of morphine used in the initial 24 hours after surgery. Adding dexmedetomidine to bupivacaine in quadratus lumborum block after cesarean section significantly decreased postoperative morphine use, with bradycardia in 3 patients and hypotension in 2.
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