Iranian Journal of Medical Sciences (Mar 2010)
The Effect of Subcutaneous Dexamethasone Added to Bupivacaine on Postcesarean Pain: A Randomized Controlled Trial
Abstract
Background: Previous studies have shown a prolonged blockadeof nerves using bupivacaine-dexamethasone microspheres. Thegoal of this study was to assess the effect of subcutaneous dexamethasoneadded to bupivacaine on post cesarean pain.Methods: After randomization, 75 healthy parturients wereallocated into three groups and received the following treatments:group A: bupivacaine 0.25% (20 ml, subcutaneously[s.c]) plus dexamethasone 16 mg (4 ml, s.c) plus normal saline(4 ml, intravenously [i.v]); group B: bupivacaine 0.25% (20ml, s.c) plus dexamethasone 16 mg (4 ml, i.v) plus normalsaline (4 ml, i.v); group C: bupivacaine 0.25% (20 ml, s.c)plus normal saline (4 ml, s.c) plus normal saline (4 ml, i.v).The visual analog scale (VAS), meperidine consumption, andtime to first meperidine consumption were evaluated in therecovery room, 6, 12, 24, 48, and 72 hours postoperatively.Results: The mean VAS in group A was less than groups Band C at 12, 24 , 48 and 72 hours after surgery (A< C< B respectively).The decrease in VAS was statistically significantbetween groups A, B and B, C (P=0.009 and P=0.015 respectively).The mean VAS in group A was significantly less thangroup C at 48 and 72 hours postoperatively (P=0.020 andP=0.024 respectively). Meperidine consumption was lower ingroup A compared with B and C groups, however it was notstatistically significant (P=0.25 and P=0.11 respectively).Conclusion: The addition of subcutaneous dexamethasone tobupivacaine prolonged the analgesia during 48-72 hours postoperatively.It may be an option for longer pain relief aftercesarean section.Trial Registration Number: IRCT138809242405N3
