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The Adjunctive Effect of Quercetin on Postoperative Pain Management Following Cesarean Section: A Randomized Controlled Study.

  • 2025-07-14
  • Drug design, development and therapy 19
    • Eman Mohamed Elmokadem
    • Dina Khaled Abou El Fadl
    • Ahmed M Bassiouny
    • Maisa Mohamed Abd Elkhalik Mahmoud
    • Mohammed Samy
    • Nouran Omar El Said

Study Design

Type
Randomized Controlled Trial (RCT)
Sample size
n = 80
Population
80 women undergoing elective cesarean section under spinal anaesthesia
Methods
prospective, double-blinded, randomized controlled trial, 500 mg oral Quercetin or matching placebo one hour before surgery
Blinding
Double-blind
Duration
24 hours post-surgery
Funding
Unclear

Purpose

 Post-cesarean section pain management remains a crucial challenge in obstetric care, with implications for maternal recovery, mother-child bonding, and long-term health outcomes. Quercetin, a naturally occurring flavonoid with anti-inflammatory and antioxidant properties, has shown promising analgesic effects in preclinical studies but has limited clinical evidence for acute pain management. This study aimed to assess the efficacy of preoperative Quercetin administration on acute post-operative pain following cesarean section.

Patients and methods

 In this prospective, double-blinded, randomized controlled trial, 80 patients undergoing elective cesarean section under spinal anaesthesia were randomly allocated to receive either 500 mg oral Quercetin (n=40) or matching placebo (n=40) one hour before surgery. The primary outcome was postoperative pain intensity assessed using a 10 cm Visual Analog Scale (VAS) at 2, 6, 12, and 24 hours after surgery. Secondary outcomes included time to first analgesic request, total morphine consumption, incidence of postoperative nausea and vomiting, time to physical activity initiation, functional activity, patient satisfaction, and adverse effects.

Results

 The Quercetin group demonstrated significantly lower VAS scores at all measured time points (p<0.001) and delayed time to first analgesic request (3.9±1.3 vs 2.73±0.78 hours, p<0.001) compared to the placebo group. Additionally, patients receiving Quercetin initiated physical activity significantly earlier (15.2±1.9 vs 19.03±2.66 hours, p<0.001) and reported higher satisfaction levels on postoperative day 2 (p=0.042). However, total morphine consumption, functional activity, incidence of nausea and vomiting, and hospital length of stay were comparable between groups, with no significant differences in adverse effects.

Conclusion

 Preoperative administration of 500 mg Quercetin significantly reduced postoperative pain and delayed the need for rescue analgesia following cesarean section, allowing for earlier mobilization without increasing adverse effects. These findings suggest Quercetin may serve as a safe, effective adjunct in multimodal pain management protocols for cesarean delivery.

Clinical trial registration

NCT06650891 (2024-10-21).

Research Insights

Adverse Events Reported

  • Quercetin→Overall tolerability

    total morphine consumption, functional activity, incidence of nausea and vomiting, and hospital length of stay were comparable between groups, with no significant differences in adverse effects.

    Finding
    No significant difference
    Significant
    No
  • Quercetin→postoperative nausea and vomiting

    total morphine consumption, functional activity, incidence of nausea and vomiting, and hospital length of stay were comparable between groups, with no significant differences in adverse effects.

    Finding
    No significant difference
    Significant
    No
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