This randomized, double-blind, controlled clinical trial will compare the effectiveness of a single intravenous dose of magnesium sulphate versus dexamethasone as an adjuvant to ultrasound-guided transversus abdominis plane (TAP) block for postoperative pain management after elective cesarean section. Eighty women undergoing elective lower-segment cesarean section under spinal anesthesia will be randomly allocated into two groups of 40 participants each. Group M will receive intravenous magnesium sulphate 50 mg/kg diluted in 100 mL normal saline, while Group D will receive intravenous dexamethasone 8 mg diluted in 100 mL normal saline. The study will assess postoperative pain using the Visual Analog Scale at 2, 4, 8, 12, and 24 hours after surgery, as well as duration of analgesia, rescue analgesic requirement, total tramadol consumption, and adverse effects. The study aims to determine whether either intravenous adjuvant provides more effective and prolonged postoperative analgesia when used with ultrasound-guided TAP block after cesarean section.
Women aged 18-40 years.
Undergoing elective lower-segment cesarean section under spinal anesthesia.
American Society of Anesthesiologists (ASA) physical status I or II.
Singleton, full-term pregnancy with gestational age of at least 37 weeks.
Known allergy or contraindication to magnesium sulphate, dexamethasone, or local anesthetics.
History of chronic pain disorders or regular use of analgesics or opioids.
Neurological, renal, hepatic, or cardiovascular disease.
Pregnancy complications such as pre-eclampsia, eclampsia, or placenta previa.
Parallel
Magnesium Sulphate 500 mg
DrugMagnesium sulphate 50 mg/kg diluted in 100 mL normal saline, administered as a single intravenous dose 15 minutes before the ultrasound-guided TAP block.
Dexamethasone
DrugDexamethasone 8 mg diluted in 100 mL normal saline, administered as a single intravenous dose 15 minutes before the ultrasound-guided TAP block.
Duration of analgesia
Time from administration of the ultrasound-guided TAP block until the participant's first request for rescue analgesia, measured in minutes.
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