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Background: The primary objective of this randomized, double-blind, parallel-group trial is to evaluate the efficacy and safety of intrathecal hyperbaric bupivacaine in conjunction with either fentanyl or dexmedetomidine in mitigating visceral pain during cesarean delivery.
Method: One hundred and sixteen parturients, classified as ASA II-III and scheduled for elective cesarean section, will be randomized 1:1 into two groups: Group BF will receive 10 mg hyperbaric bupivacaine in combination with 10 µg fentanyl. In contrast, Group BD will receive 10 mg hyperbaric bupivacaine in combination with 5 µg dexmedetomidine. The primary outcome is the frequency and intensity of visceral pain, assessed using an 11-point numerical rating scale at pivotal intraoperative stages. Secondary outcomes include hemodynamic stability, neonatal Apgar scores, shivering frequency, and the incidence of adverse effects.
Conclusion: The primary hypothesis of this study is that dexmedetomidine may offer superior visceral pain control with a reduced incidence of adverse effects.
Making Cesarean Births More Comfortable: Comparing Two Pain Relief Medicines Used in A cesarean birth (C-section) is often done under spinal anesthesia, which numbs the lower body, while the mother stays awake. While this works well for most women, some still feel uncomfortable or experience painful sensations in their belly during surgery, especially when the uterus is touched or moved. This kind of deep belly pain is called visceral pain.
Clinical Trial Registration: www.clinicaltrials.gov identifier is NCT06367660; Nepal Health Research Council (NHRC) Protocol ID: 98-2024.
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http://dx.doi.org/10.1080/17581869.2025.2543232 | DOI Listing |
Cureus
July 2025
Department of Anaesthesiology, Peoples College of Medical Sciences and Research Centre, Bhopal, IND.
Background: Spinal anesthesia (SA) with a bolus dose provides a rapid onset but often leads to hemodynamic instability, particularly in elderly patients. Fractionated dosing of hyperbaric bupivacaine may offer a dense block with greater stability and prolonged analgesia. This study compares the effects of bolus and fractionated dosing on hemodynamic parameters in elderly patients undergoing lower limb surgeries.
View Article and Find Full Text PDFReports (MDPI)
August 2025
Clinic of Anesthesia, Intensive Therapy and Pain Treatment, University Clinical Center of Vojvodina, Hajduk Veljkova 1-10, 21000 Novi Sad, Serbia.
Single-shot spinal anesthesia for intrapartum Cesarean section has recently been incriminated in carrying a high risk of high neuraxial block (HNB) occurrence in parturients receiving labor epidural analgesia. The so-called volume effect of the epidurally injected solution causes a contraction of the dural sack and unexpected HNB. We present two cases of HNB in parturients receiving epidural analgesia.
View Article and Find Full Text PDFMed Gas Res
June 2026
Department of Kinesiology, University of Texas at Arlington, Arlington, TX, USA.
Although hyperbaric oxygen therapy (HBOT) is promising for the alleviation of limb trauma or crush muscle injuries, critical examination of the state of related science is lacking. We conducted a scoping review and evaluation of HBOT on muscle injury in preclinical models. A search of PubMed and Web of Science databases yielded 157 reports published from the start of the databases until November 7, 2024, which narrowed to 19 after removing duplicates, non-muscle studies, and dissertations/reviews.
View Article and Find Full Text PDFBackground and objective Postoperative pain management following cesarean section under spinal anesthesia remains a significant clinical challenge, with limited analgesic duration frequently necessitating rescue interventions. Dexamethasone, a synthetic corticosteroid with established anti-inflammatory and analgesic properties, has demonstrated potential for prolonging neuraxial anesthesia effects. This randomized controlled trial (RCT) aimed to evaluate the efficacy of perioperative single-dose systemic dexamethasone versus placebo for prolongation of postoperative analgesia in term parturients undergoing cesarean section under spinal anesthesia, with secondary assessment of antiemetic and anti-shivering effects.
View Article and Find Full Text PDFJ Nepal Health Res Counc
June 2025
Department of Anesthesiology, Tribhuvan University Teaching Hospital, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
Background: Visceral pain occurred during cesarean delivery during spinal anesthesia can be decreased with a higher dose of bupivacaine. However, larger doses of bupivacaine increases the risk of high sensory block. We hypothesized that addition of fentanyl to bupivacaine intrathecally could intensifies the sensory block and improves the quality of intraoperative analgesia.
View Article and Find Full Text PDF