Objective: To evaluate therapeutic yield of tranexamic acid (TXA) injection and fluid co-load on the outcome of cesarean section (CS) conducted under spinal anesthesia Study Design : Prospective randomized comparative study. Patients and Methods: The current included 174 primipara scheduled for elective CS under spinal anesthesia. Intravenous (IV) fluid co-load (15 ml/kg warm lactated ringer solution) started as fast drip during and continued after spinal anesthesia. Patients were randomly allocated into two equal groups: Group TXA received a loading IV dose of 500 mg TXA 20 minutes before surgery followed by continuous TXA infusion at rate of 1 mg/kg/min till end of surgery. Group C did not receive prophylactic TXA, but both groups received a booster dose of 2 gm TXA if required. Patients were monitored for the frequency and severity of hypotension and dose of ephedrine used. Amount of bleeding since skin incision till 2-hours postpartum (PP), the frequency of patients had stopped PP bleeding till 2-hr PP and the total dose of oxytocin drugs and booster doses of TXA were recorded. Results: Hypotension was recorded in 53 patients (30.5%); only 12 patients had blood pressure <80 mmHg. The lowest blood pressure, frequency of hypotension, time of occurrence and duration of hypotension and the used dose of ephedrine showed non-significant difference between both studied groups. The amount of perioperative bleeding was significantly lower in TXA group compared to control group. Twenty parturient had continued PP bleeding for more than 2 hours PP with significantly (p=0.038) lower frequency of bleeders in TXA group. All women had continued bleeding received booster doses of TXA with a significantly higher dose in control group compared to TXA group. Conclusion: Preoperative administration of TXA significantly reduced perioperative bleeding with significant reduction of consumption of TXA booster doses and utrotonics without affecting safety. Fluid coloading allowed reduction of the frequency and extent of hypotension concomitant with spinal anesthesia.

In the postoperative period, about 20-80 percent of patients report moderate-to-severe pain. Thermal, mechanical, or chemically caused tissue damage are among the most common causes of postoperative pain. It is mainly nociceptive in nature. The goal of this study is to examine all techniques and medicines used for postoperative pain management, with a focus on all new developments in the treatment of postoperative pain. Methods: As you can see, it's a review of There was a search done using the following media keywords in MEDLINE, Embase, Pubmed, and CINAHL Plus in the same time period from 2000 to 2021: Articles written in languages other than English are not eligible for evaluation. Finally, the outcomes are as follows: When it comes to postoperative pain treatment, opioids are still the go-to option, but the current opioid crisis is driving doctors to explore alternative options that utilise a variety of pain management modalities. Other pain-relieving receptors in the spinal cord are targeted by these pathways instead of opioid receptors in the brain and body. When administered as a single dose, local anaesthetics, whether infiltrated locally or utilised in regional anaesthesia methods, have a short half-life. Extended postsurgical pain treatment using local anaesthetics may be achieved by utilising patient-controlled analgesia pumps or by combining them with other analgesics such as epinephrine, dexamethasone, or clonidine.