Ultrasound-Guided Bilateral Transversalis Fascia Plane Block With vs Without Dexamethasone for Cesarean Delivery

NCT07736989 | Not Yet Recruiting

• 1 other identifier: TFPBinCD
• Study Type: observational
• Target: 70
• Locations: 0 countries
• Sites: N/A

Brief Summary

Cesarean delivery is one of the most frequently performed surgical procedures worldwide, and effective postoperative pain management is essential to facilitate early mobilization, maternal-infant bonding, breastfeeding, and overall recovery. Ultrasound-guided transversalis fascia plane block (TFPB) has become an increasingly utilized component of multimodal analgesia following cesarean delivery because it provides effective somatic analgesia of the lower anterior abdominal wall. Adjuvants such as dexamethasone are frequently added to local anesthetics with the aim of prolonging block duration and improving postoperative analgesia; however, evidence regarding the clinical benefits of dexamethasone as an adjunct in TFPB remains limited. At our institution, bilateral ultrasound-guided TFPB is routinely performed for postoperative analgesia in patients undergoing cesarean delivery under spinal anesthesia, provided there is no contraindication and informed consent has been obtained. According to the treating anesthesiologist's routine clinical preference, dexamethasone may be added to the local anesthetic solution in some patients, whereas others receive local anesthetic alone. This retrospective cohort study will review the medical records and postoperative follow-up forms of patients who underwent cesarean delivery between November 1, 2025, and June 30, 2026. Postoperative analgesic outcomes, including opioid consumption, pain scores, time to first analgesic request, postoperative nausea and vomiting, recovery quality, and block-related adverse events, will be compared between patients receiving bilateral TFPB with dexamethasone and those receiving bilateral TFPB without dexamethasone. The findings are expected to provide real-world evidence regarding the potential contribution of dexamethasone to the analgesic efficacy of bilateral TFPB following cesarean delivery.

Conditions

Pain, Postoperative; Analgesia

Outcome Measures

Primary Outcomes (1)

• Cumulative opioid consumption during the first 24 postoperative hours

  Total opioid consumption delivered through the patient-controlled analgesia device during the first 24 hours after surgery, expressed in mg. Patients were instructed to use the PCA device when the Numeric Rating Scale pain score was 4 or higher.

  First 24 hours after surgery

Secondary Outcomes (3)

• Postoperative pain intensity

  1, 3, 6, 9, 12, 18, and 24 hours after surgery

• Time to first analgesic request

  Within the first 24 postoperative hours

• Quality of postoperative recovery

  24 hours after surgery

Study Arms (2)

TFPB + Dexamethasone

Patients who received bilateral ultrasound-guided transversalis fascia plane block with 25 mL of 0.25% bupivacaine per side plus 8 mg dexamethasone for postoperative analgesia following cesarean delivery under spinal anesthesia.

TFPB Alone

Patients who received bilateral ultrasound-guided transversalis fascia plane block with 25 mL of 0.25% bupivacaine per side for postoperative analgesia following cesarean delivery under spinal anesthesia.

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Adult women who underwent elective cesarean delivery under spinal anesthesia and received bilateral ultrasound-guided transversalis fascia plane block with or without dexamethasone for postoperative analgesia between November 1, 2025, and June 30, 2026, at our institution.

You may qualify if:

• Female patients aged 18-50 years.
• Elective cesarean delivery performed under spinal anesthesia.
• Bilateral ultrasound-guided transversalis fascia plane block performed for postoperative analgesia.
• Availability of complete perioperative and postoperative follow-up records.

You may not qualify if:

• Emergency cesarean delivery.
• General anesthesia or combined spinal-epidural anesthesia.
• Contraindication to transversalis fascia plane block.
• Chronic opioid use.
• Allergy to bupivacaine or dexamethasone.
• Missing or incomplete postoperative follow-up data.

Sponsors & Collaborators

• Bahçeşehir University: lead

Related Publications (2)

• Cadirci DY, Aydin ME, Ahiskalioglu EO, Celik EC, Yayik AM, Coruh S, Senocak GNC, Ciftci B, Ahiskalioglu A. Intrathecal morphine versus transversalis fascia and transversus abdominis plane blocks combination on obstetric quality of recovery after cesarean delivery: a randomized controlled trial. BMC Anesthesiol. 2025 Dec 17;26(1):46. doi: 10.1186/s12871-025-03559-0.

  PMID: 41408168 BACKGROUND

• Dost B, DE Cassai A, Bugada D, Balzani E, Karapinar YE, Beldagli M, Ozkal Yalin MS, Tulgar S, Ahiskalioglu A. The analgesic effect of transversalis fascia plane block after cesarean delivery: a systematic review and meta-analysis with trial sequential analysis. Minerva Anestesiol. 2025 Jun;91(6):564-572. doi: 10.23736/S0375-9393.25.18771-3.

  PMID: 40693479 BACKGROUND

MeSH Terms

Conditions

Pain, Postoperative; Agnosia

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms; Perceptual Disorders; Neurobehavioral Manifestations; Nervous System Diseases

Central Study Contacts

Selma Kahyaoglu

CONTACT

+905053705332; sbasyigit@gmail.com

selma basyigit

CONTACT

+905053705332; sbasyigit@gmail.com

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor in anesthesiology

Study Record Dates

• First Submitted: July 27, 2026
• First Posted: July 30, 2026
• Study Start (Estimated): August 3, 2026
• Primary Completion (Estimated): August 10, 2026
• Study Completion (Estimated): August 15, 2026
• Last Updated: July 30, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share