Comparison of local and intra venous dexamethasone on post operative pain and recovery after caeseream section. A randomized controlled trial

Ahmed M Maged; Wesam Sayed Deeb; Sahar Elbaradie; Ahmed R Elzayat; Ahmed A Metwally; Mohamed Hamed; Ahmed Shaker

doi:10.1016/j.tjog.2018.04.004

Comparison of local and intra venous dexamethasone on post operative pain and recovery after caeseream section. A randomized controlled trial

Taiwan J Obstet Gynecol. 2018 Jun;57(3):346-350. doi: 10.1016/j.tjog.2018.04.004.

Authors

Ahmed M Maged¹, Wesam Sayed Deeb², Sahar Elbaradie², Ahmed R Elzayat³, Ahmed A Metwally³, Mohamed Hamed⁴, Ahmed Shaker⁵

Affiliations

¹ Obstetrics and Gynecology Department, Kasr AlAiny Hospital, Cairo University, Egypt. Electronic address: prof.ahmedmaged@gmail.com.
² Obstetrics and Gynecology Department, Fayoum University, Egypt.
³ Obstetrics and Gynecology Department, Kasr AlAiny Hospital, Cairo University, Egypt.
⁴ Anaesthesia and Pain Department, Fayoum University, Egypt.
⁵ Anaesthesia and Pain Department, National Cancer Institute, Cairo University, Egypt.

PMID: 29880162
DOI: 10.1016/j.tjog.2018.04.004

Abstract

Objective: To compare the effect of local infiltration and intravenous dexamethasone on postoperative pain and recovery after Cesarean Section (CS).

Material and methods: A Prospective, randomized study conducted on 120 pregnant women attending the labor wards. All participants were scheduled for elective CS under spinal anaesthesia and were randomly divided into 3 equal groups. Group 1 received 16 mg Dexamethasone IV drip. Group II received 16 mg Dexamethasone subcutaneous injection around the caesarean section scar after skin closure and Group III received Placebo (500 cc saline infusion). All cases were followed up for 48 h for assessment of level of pain by using a 10-cm visual analog scale (VAS). Primary outcome parameters were VAS score and the need for additional analgesics. Other parameters were hemodynamic changes and occurrence of side effects or complications.

Results: there was a highly statistically significant difference between placebo and local infiltration groups and between the placebo and IV groups regarding the needs for postoperative morphine. Comparing both interventional groups revealed statistically significant difference between local infiltration and IV groups regarding the needs for postoperative morphine.

Conclusion: Local infiltration of dexamethasone is more effective than systemic administration to decrease postoperative pain with weaker antiemetic effect. NCT02784340.

Keywords: Cesarean section; Dexamethasone; Postoperative pain.

Publication types

Multicenter Study
Randomized Controlled Trial

MeSH terms

Administration, Intravenous*
Adult
Analgesics, Opioid / therapeutic use
Analysis of Variance
Cesarean Section / adverse effects*
Dexamethasone / administration & dosage*
Female
Glucocorticoids / administration & dosage*
Humans
Injections, Subcutaneous*
Morphine / therapeutic use
Pain Measurement / methods
Pain, Postoperative / prevention & control*
Pregnancy
Prospective Studies
Single-Blind Method
Visual Analog Scale
Young Adult

Substances

Analgesics, Opioid
Glucocorticoids
Morphine
Dexamethasone

Associated data

ClinicalTrials.gov/NCT02784340