STUDY OF EFFICACY OF DEXAMETHASONE AS PREEMPTIVE ANALGESIC IN PATIENTS UNDERGOING TOTAL ABDOMINAL HYSTERECTOMY UNDER SPINAL ANAESTHESIA: PROSPECTIVE OBSERVATIONAL STUDY
Main Article Content
Keywords
Postoperative pain, Visual analogue score, PONV, Intravenous, dexamethasone, Spinal anesthesia.
Abstract
Abstract
Background: Spinal anesthesia is widely used in lower abdominal surgeries, as it plays a crucial role in relieving postoperative pain and enabling ambulatory anesthesia. However, the effect of the block tends to be relatively short, prompting the use of various adjuvants to prolong the duration of the sensory block. Aim: To assess the effect of preemptive Dexamethasone on postoperative analgesia in patients undergoing total abdominal hysterectomy under subarachnoid block.
Methods: A profile of eighty patients between the ages of 18 and 60 with ASA I- II classification scheduled for total abdominal hysterectomy surgery under spinal anesthesia using hyperbaric bupivacaine 0.5% were randomly divided into two groups: the dexamethasone group ( Group D) and the control Group (Group C), with 40 patients in each group. Before the administration of spinal anesthesia, the Group D received an intravenous infusion of 8 mg dexamethasone in 100 mL normal saline, while the Group C received 100 mL normal saline only. Outcome measures included the total duration of sensory and motor blocks, VAS score, time of first analgesic request, total analgesic consumption within the first 24 h, and the occurrence of any side effects.
Results: The Group D had significantly delayed onset of 2 dermatomes regression (P < 0.001) compared to the control group (Group C). Additionally, the Group D had significantly longer duration of both sensory block and motor block (P < 0.001). VAS scores at rest and movement, total analgesic dose required were higher in Groups C as compared to group D. Total analgesic dose required were significantly greater in Group C as compared to group D. PONV scores were lower in group D significantly than control Group (C). No any immediate side effects observed among the study population.
Conclusion: Intravenous administration of dexamethasone improved postoperative VAS scores compared to the control group and decreased overall postoperative analgesic consumption. Therefore, it can be considered a valuable addition to postoperative multimodal analgesia strategies, aiming to minimize total analgesic consumption in patients undergoing abdominal hysterectomy to produces better postoperative analgesia with added antiemetic benefit
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Dr. Preeti Jamwal
Senior Resident, Department of Anesthesia Government Medical College Kathua, India.
Dr. Shivani Sharma
Senior Resident, Department of Anaesthesia Government Medical College Jammu, India.
Dr. Deepika Jamwal
Consultant, Department of gynaecology and obstetrics, Government Medical College Kathua, India.