Adjuvants in transversus abdominis plane blocks to prolong analgesia duration following cesarean delivery: A systematic review and network meta-analysis
Authors' conclusion
With the high heterogeneity and the low or very low quality of the evidence, clonidine, dexamethasone, and dexmedetomidine may prolong analgesia after CD without intrathecal morphine when used as adjuvants in TAP blocks. Furthermore, dexamethasone and dexmedetomidine appear preferable when basic analgesics are administered.
Study context
- Population
- Women receiving single-shot transversus abdominis plane (TAP) block after cesarean delivery, without intrathecal morphine39 RCTs
- Comparison
- Adjuvant added to LA vs LA alone in single-shot TAP block
- Outcome
- Time to first analgesia request
Methodological detailsBayesian random-effects
- Bayesian random-effects
Pooled result
As reported in the abstract
Each group vs LA aloneDifference, h (95 % CrI)
Clonidine
6.9(4.5–9.4)
Dexamethasone
5.8(4.2–7.4)
Dexmedetomidine
4.1(2.7–5.5)
Magnesium sulfate
3.2(0.9–5.7)
Further pooled results
Time to first analgesic request, outlier analysis and subgroup receiving basic analgesics (subgroup)
- Dexamethasone ranked first; magnesium ineffective
Postoperative opioid consumption and pain scores
- Adjuvants had minimal clinical impact
Original publication
Adjuvants in transversus abdominis plane blocks to prolong analgesia duration following cesarean delivery: A systematic review and network meta-analysis. J Clin Anesth. Published 10 November 2025. doi:10.
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