HIỆU QUẢ GIẢM ĐAU SAU PHẪU THUẬT LẤY THAI CỦA LEVOBUPIVACAIN 0,375% PHỐI HỢP DEXAMETHASON 4MG HOẶC 8MG TRONG GÂY TÊ CƠ VUÔNG THẮT LƯNG DƯỚI HƯỚNG DẪN SIÊU ÂM

Abstract

This study aims to compare the postoperative analgesic efficacy of a single dose of 0.375% Levobupivacaine combined with either 4 mg or 8 mg of Dexamethasone in ultrasound-guided Quadratus Lumborum Block (QLB) for cesarean section. From December 2023 to April 2024, a prospective interventional clinical trial was conducted involving women aged 18-50 years, ASA II, weighing ≥50 kg, with a transverse abdominal incision, who underwent spinal anesthesia for cesarean section and received postoperative QLB. Patients were randomly assigned to receive postoperative analgesia either with QLB using 4 mg Dexamethasone combined with Levobupivacaine (LD4) or with QLB using 8 mg Dexamethasone combined with Levobupivacaine (LD8). There was a trend towards a decrease in the average heart rate at 48 hours (H48) compared to baseline (H0) in both the LD4 and LD8 groups. Statistically significant differences in average heart rate between the LD4 and LD8 groups were observed at 12 hours (H12) and 18 hours (H18) (p < 0.05). Additionally, there was a trend towards a decrease in average blood pressure at H48 compared to H0 in both groups. The average heart rate showed significant statistical differences between LD4 and LD8 groups at H12 and H18 (p<0.05). There was a trend towards a reduction in average Visual Analog Scale (VAS) scores for both rest and movement at postoperative time points compared to H0 in both LD4 and LD8 groups. However, the differences in VAS scores for rest and movement between the two groups were not statistically significant (p>0.05). The analgesic efficacy of 0.375% Levobupivacaine combined with 4 mg or 8 mg of Dexamethasone in postoperative ultrasound-guided QLB for cesarean section is comparable. All patients were satisfied with the analgesia and no postoperative complications were reported.