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CompletedNCT07257406Updated Aug 5, 2026

Dexamethasone for Post-operative Pain After Cesarean Delivery Under Neuraxial Anesthesia.

An interventional study of Dexamethasone (IV) and Placebo in Pregnancy, Cesarean Delivery and Dexamethasone, sponsored by Valerie Zaphiratos. Completed at 1 site in Canada. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-08-05.

Sponsored by Valerie Zaphiratos · Not applicable, Interventional, and Prevention

From the registry’s dates

  • Registered 7 years 2 months after the study started (first participant enrolled Sep 2018, registered Nov 2025).
Phase
Not applicable
Study type
Interventional
Enrollment
87
Allocation
Randomized
Ages
18 Years and older
Sex
Female
01

Study summary

After surgery pain in women who have had a cesarean delivery is a determining factor in the quality and duration of their hospital stay. Insufficient pain relief can lead to longer hospitalization and long term pain, which can result in long term use of pain medication. A classic method to alleviate pain after cesarean delivery is by injecting morphine into the spinal fluid, in the women's back, in addition to prescribing morphine by mouth as needed after the surgery. However, the negative effects associated with morphine and morphine-like drugs, limit the doses used, their pain relief capacity, and can negatively affect the after surgical experience of women. An approach which uses pain relief that acts on different pain pathways to treat after surgery pain helps limit the negative effects of different drugs. The potential benefit of dexamethasone as pain relief in women who have had a cesarean delivery is all the more interesting because of its minimal negative effects compared to morphine-like drugs. Its low cost, its effectiveness to prevent nausea, and its impact on the general condition of patients make dexamethasone even more attractive.

Read the detailed description

Postoperative pain in patients who have undergone a cesarean delivery is a determining factor in the quality and duration of their hospital stay. Suboptimal analgesia can lead to prolonged hospitalization and chronic pain, which can result in chronic use of pain medication. Treatment of post-operative pain after cesarean delivery uses intrathecal morphine, and the use of opioids as needed post-operatively. However, the side effects associated with opioids limit the doses used, their analgesic efficacy, and adversely affect the postoperative experience of patients. The multimodal approach to postoperative pain allows for analgesia that acts on different pain mechanisms while limiting the adverse effects of different drugs. The potential benefits of dexamethasone as a co-analgesic in women who have had a cesarean section are all the more interesting because of its minimal adverse effects compared to opioids. Its low cost, its effectiveness as antiemetic prophylaxis, and its impact on the general condition of patients make dexamethasone even more attractive.

In this randomised controlled trial, 100 patients are to be recruited and randomised to one of two groups. Both groups will receive standard treatment. In addition to standard treatment, the first group will receive dexamethasone 8 mg IV after umbilical cord clamping and the other group will receive a placebo.

The patients will be followed for 24 hours post-operatively. Their pain levels at rest and during movement will be recorded on an 11 point pain scale. The dose of hydromorphone used in the first 24 hours will be recorded. The patients are also asked to complete the QOR-40 questionnaire, which aims to assess the quality of their postoperative recovery. The primary outcome is the pain on an 11 point scale at the first rise 6 hours post-operatively.

The investigators hypothesize that dexamethasone will improve pain scores and diminish opioid use in the first 24 hours post-operatively.

02

Conditions studied

  • Pregnancy
  • Cesarean Delivery
  • Dexamethasone

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Keywords

  • pregnancy
  • dexamethasone
  • cesarean
  • pain
03

In context

Pain

2,219 studies on the registry are indexed under Pain; 917 are open to participants now.

This study's enrollment of 87 is above the median of 70 across 1,904 interventional studies indexed under Pain.

Browse Pain studies →

Lead sponsor

This is the only study on the registry with Valerie Zaphiratos as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Age ≥ 18 years
  • Cesarean delivery
  • Planned spinal or combined neuraxial anesthesia
  • Presence of an investigator in the delivery room
  • Pregnancy > 34 weeks gestation

Exclusion criteria

Exclusion Criteria:

  • Cesarean delivery under general anesthesia
  • Inability to understand French or English
  • Allergy or hypersensitivity to dexamethasone
  • Allergy to hydromorphone
  • Allergy to NSAIDs
  • Acute kidney injury or chronic kidney failure
  • Preeclampsia
  • Extremely urgent cesarean section
  • Urgent cesarean section with non-reassuring fetal monitoring
  • Known maternal heart disease
  • High-grade placental abnormality
  • Diabetes (pregnancy or pre-existing)
  • Systemic infection, sepsis, fever
  • Regular use of dexamethasone in the last year
  • Weight greater than 120 kg and less than 70 kg
  • Height less than 150 cm
  • Chronic pain and/or chronic use of opioids
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Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
87 participants (actual)

Study arms

  • Active comparator
    Dexamethasone

    Participants who receive dexamethasone 8 mg IV (2 ml) 5 min after cord clamping.

    Drug: Dexamethasone (IV)

  • Placebo comparator
    Placebo

    Participants who receive 0.9% saline IV (2 ml) 5 min after cord clamping.

    Drug: Placebo

Interventions

  • DrugDexamethasone (IV)

    Dexamethasone 8 mg IV will be given 5 minutes after cord clamping in the interventional arm.

  • DrugPlacebo

    This arm will receive 2 ml of saline 5 min after cord clamping.

06

What researchers measure

Primary outcomes

  1. Visual Analog Pain Score (VAS) 6 hours post-operatively at first rise

    Visual Analog Pain Score (VAS), from 0 to 10, when patients first stand out of bed 6 hours post-operatively. A score of 0 on 10 being no pain, and a score of 10 on 10 being the worst pain imaginable.

    Time frame: 6 hours post-operatively

07

Study locations

1 site
  • CHU Sainte-Justine
    Montreal, Quebec H2V 4K8, Canada
08

References and documents

Publications

  • Mohtadi A, Nesioonpour S, Salari A, Akhondzadeh R, Masood Rad B, Aslani SM. The effect of single-dose administration of dexamethasone on postoperative pain in patients undergoing laparoscopic cholecystectomy. Anesth Pain Med. 2014 Aug 13;4(3):e17872. doi: 10.5812/aapm.17872. eCollection 2014 Aug. PubMed 25237639 ↗
  • Shahraki AD, Feizi A, Jabalameli M, Nouri S. The effect of intravenous Dexamethasone on post-cesarean section pain and vital signs: A double-blind randomized clinical trial. J Res Pharm Pract. 2013 Jul;2(3):99-104. doi: 10.4103/2279-042X.122370. PubMed 24991614 ↗
  • Cardoso MM, Leite AO, Santos EA, Gozzani JL, Mathias LA. Effect of dexamethasone on prevention of postoperative nausea, vomiting and pain after caesarean section: a randomised, placebo-controlled, double-blind trial. Eur J Anaesthesiol. 2013 Mar;30(3):102-5. doi: 10.1097/EJA.0b013e328356676b. PubMed 23022704 ↗

Individual participant data

Plan to share: Yes — If a researcher needs IPD for a meta-analysis for instance, they can contact me.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 5, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT07257406
Lead sponsor
Valerie Zaphiratos
Collaborators
Université de Montréal
Responsible party
Valerie Zaphiratos (Associate Professor of Anesthesiology, St. Justine's Hospital) — Sponsor-investigator
First posted
Dec 2, 2025
Start date
Sep 13, 2018
Primary completion
Jun 8, 2021
Completion
Jan 20, 2026
Last update
Aug 5, 2026

Study contacts

Valerie Zaphiratos, MD MSc FRCPC
principal investigator · CHU Sainte-Justine, Université de Montréal

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.

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