Study Of Efficacy Of Dexamethasone As Preemptive Analgesic In Patients Undergoing Total Abdominal Hysterectomy Under Spinal Anaesthesia: A Randomised Controlled Trial

Abstract

Background: Dexamethasone is an analgesic and anti-emetic agent, that decreases analgesic consumption, yet improve post-operative analgesia. Objectives: To assess the effect of preemptive Dexamethasone on postoperative analgesia as primary objective. To assess the effect of preemptive Dexamethasone on occurrence of PONV and to study any immediate side effects of Dexamethasone if any as secondary objectives. Study Design: This is a randomized, double-blind, and placebo-controlled trial conducted over 120 patients undergoing total abdominal hysterectomy under subarachnoid block. Patients were randomized into three groups Group A - Inj. Dexamethasone 8 mg in 10 ml of Normal Saline preemptively + Inj Normal Saline 10 ml IV intraoperatively. Group B- Inj Normal Saline 10ml IV preemptively + Inj. Dexamethasone 8 mg in 10 ml Normal Saline IV intraoperatively. Group C- Inj Normal Saline 10ml IV preemptively + Inj Normal Saline 10ml IV intraoperatively (control group). Postoperatively, rest and activity pain scores, total analgesic and antiemetic consumption in 24 hours, PONV score , and side effects were recorded. Results: VAS scores at rest and movement, total analgesic dose required were higher in Groups B and C as compared to group A. Total analgesic dose required were significantly greater in Group B as compared to group A. PONV scores are comparable between group A and group B and significantly lower than control (C). No any immediate side effects observed. Conclusion: Preemptively Dexamethasone at a dose of 8 mg delays patient request for analgesia and reduces total analgesic consumption postoperatively without any side effects.