Dexamethasone as an Analgesic Adjunct for Postcesarean Delivery Pain: A Randomized Controlled Trial
Objectives. Dexamethasone has been shown to have analgesic properties in the general surgical population. However, the analgesic effects for women that undergo cesarean deliveries under spinal anesthesia remain unclear and may be related to the timing of dexamethasone administration. We hypothesized...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-01-01
|
| Series: | Anesthesiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2021/4750149 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832561131743346688 |
|---|---|
| author | Jennifer E. Mehdiratta Jennifer E. Dominguez Yi-Ju Li Remie Saab Ashraf S. Habib Terrence K. Allen |
| author_facet | Jennifer E. Mehdiratta Jennifer E. Dominguez Yi-Ju Li Remie Saab Ashraf S. Habib Terrence K. Allen |
| author_sort | Jennifer E. Mehdiratta |
| collection | DOAJ |
| description | Objectives. Dexamethasone has been shown to have analgesic properties in the general surgical population. However, the analgesic effects for women that undergo cesarean deliveries under spinal anesthesia remain unclear and may be related to the timing of dexamethasone administration. We hypothesized that intravenous dexamethasone administered before skin incision would significantly reduce postoperative opioid consumption at 24 h after cesarean delivery under spinal anesthesia with intrathecal morphine. Methods. Women undergoing elective cesarean deliveries under spinal anesthesia were randomly assigned to receive 8 mg of intravenous dexamethasone or placebo prior to skin incision. Both groups received a standardized spinal anesthetic and multimodal postoperative analgesic regime. The primary outcome was cumulative opioid consumption at 24 h. Secondary outcomes included cumulative opioid consumption at 48 h, time to first analgesic request, and pain scores at rest and on movement at 2, 24, and 48 h. Results. 47 patients were analyzed—23 subjects that received dexamethasone and 24 subjects that received placebo. There was no difference in the median (Q1, Q3) cumulative opioid consumption in the first 24 hours following cesarean delivery between the dexamethasone group {15 (7.5, 20.0) mg} and the placebo group {13.75 (2.5, 31.25) mg} (P=0.740). There were no differences between the groups in cumulative opioid consumption at 48 h, time to first analgesic request, and pain scores. Conclusions. Intravenous dexamethasone 8 mg administered prior to skin incision did not reduce the opioid consumption of women that underwent cesarean deliveries under spinal anesthesia with intrathecal morphine and multimodal postoperative analgesic regimen. |
| format | Article |
| id | doaj-art-1b2415c123614328aadef5db3df39a10 |
| institution | Kabale University |
| issn | 1687-6962 1687-6970 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Anesthesiology Research and Practice |
| spelling | doaj-art-1b2415c123614328aadef5db3df39a102025-02-03T01:25:48ZengWileyAnesthesiology Research and Practice1687-69621687-69702021-01-01202110.1155/2021/47501494750149Dexamethasone as an Analgesic Adjunct for Postcesarean Delivery Pain: A Randomized Controlled TrialJennifer E. Mehdiratta0Jennifer E. Dominguez1Yi-Ju Li2Remie Saab3Ashraf S. Habib4Terrence K. Allen5Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USADepartment of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USADepartment of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC 27710, USADepartment of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USADepartment of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USADepartment of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USAObjectives. Dexamethasone has been shown to have analgesic properties in the general surgical population. However, the analgesic effects for women that undergo cesarean deliveries under spinal anesthesia remain unclear and may be related to the timing of dexamethasone administration. We hypothesized that intravenous dexamethasone administered before skin incision would significantly reduce postoperative opioid consumption at 24 h after cesarean delivery under spinal anesthesia with intrathecal morphine. Methods. Women undergoing elective cesarean deliveries under spinal anesthesia were randomly assigned to receive 8 mg of intravenous dexamethasone or placebo prior to skin incision. Both groups received a standardized spinal anesthetic and multimodal postoperative analgesic regime. The primary outcome was cumulative opioid consumption at 24 h. Secondary outcomes included cumulative opioid consumption at 48 h, time to first analgesic request, and pain scores at rest and on movement at 2, 24, and 48 h. Results. 47 patients were analyzed—23 subjects that received dexamethasone and 24 subjects that received placebo. There was no difference in the median (Q1, Q3) cumulative opioid consumption in the first 24 hours following cesarean delivery between the dexamethasone group {15 (7.5, 20.0) mg} and the placebo group {13.75 (2.5, 31.25) mg} (P=0.740). There were no differences between the groups in cumulative opioid consumption at 48 h, time to first analgesic request, and pain scores. Conclusions. Intravenous dexamethasone 8 mg administered prior to skin incision did not reduce the opioid consumption of women that underwent cesarean deliveries under spinal anesthesia with intrathecal morphine and multimodal postoperative analgesic regimen.http://dx.doi.org/10.1155/2021/4750149 |
| spellingShingle | Jennifer E. Mehdiratta Jennifer E. Dominguez Yi-Ju Li Remie Saab Ashraf S. Habib Terrence K. Allen Dexamethasone as an Analgesic Adjunct for Postcesarean Delivery Pain: A Randomized Controlled Trial Anesthesiology Research and Practice |
| title | Dexamethasone as an Analgesic Adjunct for Postcesarean Delivery Pain: A Randomized Controlled Trial |
| title_full | Dexamethasone as an Analgesic Adjunct for Postcesarean Delivery Pain: A Randomized Controlled Trial |
| title_fullStr | Dexamethasone as an Analgesic Adjunct for Postcesarean Delivery Pain: A Randomized Controlled Trial |
| title_full_unstemmed | Dexamethasone as an Analgesic Adjunct for Postcesarean Delivery Pain: A Randomized Controlled Trial |
| title_short | Dexamethasone as an Analgesic Adjunct for Postcesarean Delivery Pain: A Randomized Controlled Trial |
| title_sort | dexamethasone as an analgesic adjunct for postcesarean delivery pain a randomized controlled trial |
| url | http://dx.doi.org/10.1155/2021/4750149 |
| work_keys_str_mv | AT jenniferemehdiratta dexamethasoneasananalgesicadjunctforpostcesareandeliverypainarandomizedcontrolledtrial AT jenniferedominguez dexamethasoneasananalgesicadjunctforpostcesareandeliverypainarandomizedcontrolledtrial AT yijuli dexamethasoneasananalgesicadjunctforpostcesareandeliverypainarandomizedcontrolledtrial AT remiesaab dexamethasoneasananalgesicadjunctforpostcesareandeliverypainarandomizedcontrolledtrial AT ashrafshabib dexamethasoneasananalgesicadjunctforpostcesareandeliverypainarandomizedcontrolledtrial AT terrencekallen dexamethasoneasananalgesicadjunctforpostcesareandeliverypainarandomizedcontrolledtrial |