An interventional study of Magnesium Sulphate 500 mg and Dexamethasone in Cesarean Section Complications, sponsored by Khyber Teaching Hospital. Not yet recruiting. Open to female participants aged 18 Years to 40 Years. Per ClinicalTrials.gov, last updated 2026-08-19.
Sponsored by Khyber Teaching Hospital · Not applicable, Interventional, and Treatment
This randomized, double-blind, controlled clinical trial will compare the effectiveness of a single intravenous dose of magnesium sulphate versus dexamethasone as an adjuvant to ultrasound-guided transversus abdominis plane (TAP) block for postoperative pain management after elective cesarean section. Eighty women undergoing elective lower-segment cesarean section under spinal anesthesia will be randomly allocated into two groups of 40 participants each. Group M will receive intravenous magnesium sulphate 50 mg/kg diluted in 100 mL normal saline, while Group D will receive intravenous dexamethasone 8 mg diluted in 100 mL normal saline. The study will assess postoperative pain using the Visual Analog Scale at 2, 4, 8, 12, and 24 hours after surgery, as well as duration of analgesia, rescue analgesic requirement, total tramadol consumption, and adverse effects. The study aims to determine whether either intravenous adjuvant provides more effective and prolonged postoperative analgesia when used with ultrasound-guided TAP block after cesarean section.
Post-cesarean pain can affect maternal comfort, mobility, breastfeeding and postoperative recovery. Effective postoperative analgesia is therefore an important component of care following cesarean section. Ultrasound-guided transversus abdominis plane (TAP) block is used as part of multimodal analgesia to provide abdominal wall somatic analgesia and may reduce the requirement for systemic opioid analgesics.
This study will evaluate whether the addition of a single intravenous dose of magnesium sulphate or dexamethasone provides better postoperative analgesia when used as an adjunct to ultrasound-guided TAP block in women undergoing elective cesarean section.
The study will be conducted as a randomized, double-blind, controlled clinical trial in the Department of Anesthesia, Khyber Teaching Hospital, Peshawar. A total of 80 women will be included, with 40 participants allocated to the magnesium sulphate group (Group M) and 40 participants allocated to the dexamethasone group (Group D).
Eligible participants will be women aged 18-40 years undergoing elective lower-segment cesarean section under spinal anesthesia, with ASA physical status I or II, singleton full-term pregnancy of at least 37 weeks, and willingness to provide written informed consent.
Participants with known allergy or contraindication to magnesium sulphate, dexamethasone or local anesthetics; chronic pain disorders or regular analgesic/opioid use; neurological, renal, hepatic or cardiovascular disease; pregnancy complications such as pre-eclampsia, eclampsia or placenta previa; conversion to general anesthesia; inadequate spinal anesthesia or failed TAP block; or refusal to participate will be excluded.
Following enrollment and informed consent, participants will be randomly allocated using a computer-generated randomization list. Group M will receive a single intravenous dose of magnesium sulphate 50 mg/kg diluted in 100 mL normal saline 15 minutes before the TAP block. Group D will receive a single intravenous dose of dexamethasone 8 mg diluted in 100 mL normal saline 15 minutes before the TAP block.
All participants will receive spinal anesthesia at the L3-L4 interspace using a 25-G spinal needle and 0.5% hyperbaric bupivacaine at a dose of 10-12 mg under aseptic conditions.
Following cesarean section and stabilization in the recovery area, all participants will receive a bilateral ultrasound-guided TAP block using 20 mL of 0.25% bupivacaine on each side. The block will be performed by a skilled anesthesiologist using a high-frequency linear ultrasound probe.
Patients will be monitored during the perioperative period for heart rate, blood pressure, respiratory rate and oxygen saturation. Postoperative pain will be assessed using the Visual Analog Scale, with 0 representing no pain and 10 representing the worst imaginable pain. Pain will be assessed at 2, 4, 8, 12 and 24 hours after surgery, both at rest and on movement.
The duration of analgesia will be assessed as the time from administration of the TAP block until the patient's first request for rescue analgesia. Rescue analgesic requirement will be assessed by recording the number of rescue analgesic doses and total tramadol consumption during the first 24 postoperative hours. Each rescue dose of tramadol will be recorded as 50 mg intravenously according to the study protocol.
Adverse effects including nausea, vomiting, dizziness, sedation and allergic reactions will also be recorded. Patient satisfaction with postoperative pain control may also be assessed.
Data collection will be performed by qualified anesthesiology residents who will remain blinded to group allocation. The primary investigator will review completed data collection forms for accuracy and completeness.
The collected data will be entered and analyzed using SPSS version 26.0. Quantitative variables including age, weight, duration of analgesia and total tramadol consumption will be summarized using mean and standard deviation where appropriate. The Shapiro-Wilk test will be used to assess normality. The independent-samples t-test will be used for normally distributed continuous variables, while the Mann-Whitney U test will be used for non-normally distributed variables. Categorical variables, including adverse effects, will be presented as frequencies and percentages and compared using the Chi-square test or Fisher's exact test as appropriate. A p-value of less than 0.05 will be considered statistically significant.
The study will compare the postoperative analgesic effectiveness of intravenous magnesium sulphate and dexamethasone when used as adjuvants to ultrasound-guided TAP block. The outcomes will provide information regarding postoperative pain scores, duration of analgesia, rescue analgesic requirement, total tramadol consumption and adverse effects in women undergoing elective cesarean section.
5,640 studies on the registry are indexed under Pain, Postoperative; 1,230 are open to participants now.
This study's planned enrollment of 80 is close to the median of 75 across 4,821 interventional studies indexed under Pain, Postoperative.
Browse Pain, Postoperative studies →Khyber Teaching Hospital is the lead sponsor of 29 studies on the registry; 19 are open to participants now.
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Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
ASA physical status
The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Contraindication
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Participants in this group will receive a single intravenous dose of magnesium sulphate 50 mg/kg diluted in 100 mL normal saline, administered 15 minutes before the ultrasound-guided TAP block. Following cesarean section, participants will receive a bilateral ultrasound-guided TAP block with 20 mL of 0.25% bupivacaine on each side.
Drug: Magnesium Sulphate 500 mg
Participants in this group will receive a single intravenous dose of dexamethasone 8 mg diluted in 100 mL normal saline, administered 15 minutes before the ultrasound-guided TAP block. Following cesarean section, participants will receive a bilateral ultrasound-guided TAP block with 20 mL of 0.25% bupivacaine on each side.
Drug: Dexamethasone
Magnesium sulphate 50 mg/kg diluted in 100 mL normal saline, administered as a single intravenous dose 15 minutes before the ultrasound-guided TAP block.
Dexamethasone 8 mg diluted in 100 mL normal saline, administered as a single intravenous dose 15 minutes before the ultrasound-guided TAP block.
Duration of analgesia
Time from administration of the ultrasound-guided TAP block until the participant's first request for rescue analgesia, measured in minutes.
Time frame: From completion of the TAP block until the first request for rescue analgesia, assessed during the first 24 hours after cesarean section.
No study locations are listed for this record.
Start is estimated for Sep 2026; primary completion for Feb 2027, 5 months later.
Of 2,089 non-industry interventional studies with no phase under Pain, Postoperative, half reached primary completion within 11 months of starting (the median), counting those still running; a quarter within 6 and three quarters within 23. This study's planned 5 months is below that.
Counting every sponsor, half of 2,102 studies reached it within 11 months; a quarter within 6 and three quarters within 23.
How these figures are worked out, and which studies are left out of them.
This study is not yet recruiting, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.
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Studies of the drug tested here: Magnesium Sulfate
Khyber Teaching Hospital