Ultrasound-Guided Transversus Abdominis Plane Block For Cesarean Delivery:Injection Site Pain As A New Complication And Dexamethasone Reduced Incidence

Objective:The purpose of this study was to investigate the incidence of pain at the injection site after cesarean section and the effect of dexamethasone on injection site pain.Methods:A total of 84 cases of cesarean delivery were randomly assigned to either a ropivacaine group(groupv R)or ropivacaine+dexamethasone group(group RD)in this double-blind trial.Both groups received bilateral ultrasound-guided transversus abdominis plane block after obstetrics and analgesia.The pain site and pain degree at rest and during activity at 2,6,10,12,14,16,20 and 24 hours after maternal surgery were recorded.The consumption of opioids at 24 hours,postoperative nausea,vomiting,exhaustion,and other adverse reactions were recorded.Results:A total of 80 cases of cesarean delivery were included in the analysis of results.A total of 19 cases developed inject site pain,14 cases in the group R and 5 cases in the group RD.The incidence of inject site pain in the R and RD groups was 35% and12.5%.Respectively,the results described above showed that combining dexamethasone with ropivacaine reduced the incidence of inject site pain,and the difference was statistically significant(P<0.05).Two groups of women with positive inject site pain had higher values of opioid consumption than women with negative inject site pain,but the difference was not significant.The resting VAS scores of the parturients in the RD group at 2,6,10,12,14 and 16 hours after surgery were significantly lower than those in the R group(P<0.05),and the number of intravenous analgesia pump self-controlled compressions was less in 24 hours(P<0.05),indicating that the demand for opioids in the R group was significantly higher than that of the RD group.There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion:Dexamethasone as an adjuvant for ropivacaine can effectively relieve the inject site pain of ultrasound-guided transversus abdominis plane block after cesarean delivery,and can enhance the analgesic effect of ropivacaine.