Analgesic effect of intravenous Dexamethasone prior to Spinal Anesthesia among parturient undergo cesarean section at Gandhi Memorial Hospital, ADDIS ABABA, ETHITIOPIA, Prospective Cohort Study, 2018/19
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Date
2019-06
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Addis Ababa University
Abstract
Background: By prolonging the duration of spinal anesthesia sensory block co-administration of adjuvant has the potential to improve efficacy of regional blocks. However this technique has its own complications. Hence, drugs having minimal side effects and prolonged analgesia is always looked for. This is because postoperative pain in obstetric patients is left untreated and it’s the main cause of chronic pain among women.
Objective: to determine the effect of preoperative dexamethasone on prolongation of the analgesic effect of spinal anesthesia after elective cesarean section.
Methods: Observational prospective cohort study was conducted at Gandhi Memorial in 64 patients scheduled for elective Cesarean Section under spinal anesthesia and systematic random sampling was used to randomly select patients. Data was checked manually for completeness and then it was coded and entered, cleaned and analyzed with SPSS version 20 computer program. Normality of the data was checked by Shapiro wilk test. Chi square test was used for categorical variables and Manny Whitney test used for comparing numerical variables of skewed data or student's t-test used for comparing numerical variables normally distributed data of two groups. P-value less than 0.05 considered as statistically significant.
Result: The demographic and clinical characteristics were comparable between groups. Groups’ comparison indicated significant difference in terms of severity of postoperative pain, in which the dexamethasone group were lower with p value < 0.015. Similarly, time to the requirement of first rescue analgesia was prolonged in dexamethasone group with median (interquartile range) score of 6.5(2.4) as compared to non-dexamethasone group 4.1(1.8). The median score for total consumption of Tramadol in 24hrs post operatively has been lower in dexamethasone group with p value < 0.0001. There is no statistically significant difference in median score of total diclofenac consumption between the two groups with p value of 0.2.
Conclusion: we concluded that preoperative administration of dexamethasone 0.1mg/kg intravenously before administrating spinal anesthesia for cesarean section is efficient in reducing postoperative pain, total Tramadol consumption on the first postoperative day and prolonging the time to the requirement of first rescue analgesia.
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Spinal Anesthesia