Impact of Adding Dexmedetomidine as an Adjuvant to The Local Anesthetic in Quadratus Lumborum Block in Patient Undergoing Caesarean Section

Effective postoperative analgesia facilitates a mother's quick recovery, enhances early ambulation, promotes breastfeeding, and reduces the risk of postoperative thromboembolism. The aim of this study was to evaluate the postoperative analgesic efficacy of combining a local anesthetic with dexmedetomidine (DEX) in a quadratus lumborum block (QLB) following a cesarean section (CS). A prospective, randomized, blind, controlled trial included 80 female patients aged 18 - 40 years old who underwent cesarean delivery under spinal anesthesia, were randomly assigned to two equal groups. Group dB received a quadratus lumborum block (QLB) with 20 ml of 0.25% bupivacaine and dexmedetomidine (0.5 μg/kg) on each side, while Group B received QLB with 20 ml of 0.25% bupivacaine alone on each side. The primary outcome measured was total analgesic consumption over 24 hours postoperatively. Secondary outcomes included Visual Analog Scale (VAS) scores, time to first analgesic request, and the incidence of side effects such as sedation, nausea, vomiting, shivering, pruritus, bradycardia, hypotension, and respiratory depression.

Inclusion criteria

• Age over 18 years' old and less 40 years.
• With body mass indices (BMI) between 18.5 and 34.9 kg/m²
• Pregnancy more than 37 weeks with single fetus.
• Intact membranes.
• Women with a singleton pregnancy.

Exclusion criteria

• ASA class III or higher,
• contraindications to spinal anesthesia,
• mental or neurological disorders,
• chronic heart, renal, or liver diseases,
• emergency surgery,
• a history of blood coagulation disorders,
• allergies or contraindications to the study drugs,