ĐÁNH GIÁ HIỆU QUẢ KÉO DÀI TÁC DỤNG GIẢM ĐAU SAU PHẪU THUẬT LẤY THAI CỦA PHUƠNG PHÁP GÂY TÊ CƠ VUÔNG THẮT LƯNG HAI BÊN BẰNG ROPIVACAIN 0,375% PHỐI HỢP DEXAMETHASONE

Abstract

Objective: This study aims to evaluate the prolonged analgesic efficacy after cesarean section of bilateral quadratus lumborum block (QLB) with 0,375% ropivacaine with or without dexamethasone. Methods: A prospective, randomized, controlled clinical trial was conducted from December 2024 to August 2025. 60 parturients aged 18 – 50 years, ASA II, body weight ³ 50 kg, with a transverse abdominal incision, who underwent spinal anesthesia for cesarean section and received postoperative QLB. This patients were randomly allocated into two groups (n = 30 each). The RD group received 30ml of ropivacaine combined with 8mg dexamethasone, whereas the R group received 30ml of ropivacaine alone. Results: In the RD group, patients required rescue morphine later, and the consumption within the first 24 hours was significantly lower compare with the R group. VAS (Visual Analog Scale) Scores at rest and on movement were reduced after block administration compared with baseline in both groups. However, VAS scores in the RD group were significantly lower than the R group at 12 and 18 hours post-block (p < 0,05). Heart rate and mean arterial pressure in both groups shows a downward trend postoperatively but remain within physiological limits. All patients reported satisfaction and no severe were recorded.