A Randomized Controlled Trial Evaluating the Effect of Intravenous Dexamethasone on the Duration of Spinal Anesthesia as Part of a Multimodal Antiemetic Strategy for Enhanced Recovery After Cesarean Delivery

What this Trial Is About

Researchers are studying the effects of intravenous (IV) dexamethasone on spinal anesthesia in healthy women undergoing elective Cesarean delivery (CD). This randomized, double-blind, controlled trial aims to understand how IV dexamethasone influences the duration of motor and sensory blockade from spinal anesthesia, as well as its impact on pain, nausea, vomiting, and itching after surgery. The study compares dexamethasone to metoclopramide, another anti-nausea medication, within a multimodal antiemetic strategy as part of Enhanced Recovery After Surgery (ERAS) protocols. Participants receive a standardized spinal anesthesia with bupivacaine, fentanyl, and morphine. They are randomly assigned to receive either 10 mg of IV dexamethasone or 10 mg of IV metoclopramide immediately after spinal anesthesia. All participants also receive ondansetron as a second antiemetic. Additional anti-nausea medications may be given if needed. The study monitors motor and sensory block recovery times closely using specific assessments like the Bromage score and sensation testing at regular intervals. During the study, participants are assessed for pain, nausea, itching, and motor function recovery in the recovery room at scheduled times until full recovery of motor function is confirmed. Pain and nausea scores are recorded hourly until full motor function returns. Opioid use is tracked for 24 hours after surgery, along with any episodes of vomiting or itching. The main outcome is the time until complete resolution of motor block. The study plans to include 116 participants and is conducted with careful data collection and statistical analysis to compare the two treatment groups.

Evaluating the Effect of Intravenous Dexamethasone on the Duration of Spinal Anesthesia After Cesarean Delivery