The comparison of analgesic effect of intravenous pump dexmedetomidine with paracetamol and ketorolac with paracetamol on postoperative pain after cesarean section

The comparison of analgesic effect of intravenous pump of dexmedetomidine with paracetamol and ketorolac with paracetamol on postoperative pain after cesarean section under spinal anesthesia

This is a clinical trial study with parallel groups, double-blinded randomized, will be conducted on 60 women undergoing cesarean section with spinal anesthesia. Assignment of patients to the study groups will be done by random-numbers table and using computer.

From pregnant women candidate for cesarean section with spinal anesthesia referring to Imam Khomeini hospital, Ahvaz, total of 60 patients will be selected and randomly divided into 2 groups. The patients and experimenters will not know about type of treatment and patient grouping and thus until the end of trial the study will be remained double-blinded.

- Inclusion criteria: age between 18 to 40 years, ASA Class I and II, Candidate for elective cesarean section, No drug allergies to dexmedetomidine, ketorolac and paracetamol, stable hemodynamics, consent to participate in the study; Exclusion criteria: history of asthma, history of bleeding or gastrointestinal ulcer, severe liver disease

In the first group, Paracetamol 1 g and Dexmedetomidine 0.2 µg/kg soluted in 100 cc normal saline will be injected via analgesic pump at a rate of 4 mL/h, after surgery and before the patient entry to recovery. In the second group, Paracetamol 1 g and ketorolac 0.5 ml/kg soluted in 100 cc normal saline will be injected via analgesic pump at a rate of 4 mL/h, after surgery and before the patient entry to recovery.

Pain severity, Hemodynamic changes including systolic blood pressure, diastolic blood pressure, Heart rate, anxiety and presence of nausea and vomiting

Patients will be assigned into two groups by simple randomization method. Allocation of patients to the study groups will be done by random-numbers table and using computer, and on this basis patients will be included in one of the two treatment groups before starting intervention. The implementation of the random allocation sequence occurs without knowledge of which patient will receive which treatment.

Intervention (receiving Dexmedetomidine or Ketorolac with Paracetamol) and patient evaluation will be carried out by a physician who is blinded to both treatment groups. Also patients and statistical analyzer will not know about patient grouping.