Effect of Intravenous Dexamethasone on Spinal Anaesthesia With Bupivacaine Plus Fentanyl in Patients Undergoing Vaginal Hysterectomy

Abstract

Background: Many adjuvant drugs have been used to enhance postoperative neuraxial opioid analgesia while reducing the adverse effects. Methods: We randomized 50 patients undergoing various lower abdominal operations into 2 equal groups to receive either 2 mL saline or 0.1 mg/kg dexamethasone IV before the administration of intrathecal anesthesia (15 mg bupivacaine heavy and fentanyl 25mcg). After surgery, pain was assessed with the help of a 100mm visual analogue scale where 0 means no pain at all and 100 signifies the worst pain experience possible. The rescue analgesic was administered when the pain score exceeded 40. After administration of rescue analgesic the patients were asked to score their pain at 6, 12, 18, and 24 h. The presence of postoperative nausea and vomiting (PONV), pruritus and respiratory depression were recorded. Results: The total dose of diclofenac, visual analog scale pain score, and the incidence of PONV were significantly lower in the dexamethasone group than in control. Conclusions: Administration of IV dexamethasone prior to intrathecal fentanyl injection enhances analgesia and reduces PONV.