Background:The challenge in providing analgesia for spine surgeries is to provide extended postoperative pain relief and simultaneously allow early neurological assessment and mobilization. Our study aimed to evaluate the analgesic efficacy of intravenous versus caudal dexamethasone in lumbosacral spine surgeries.Materials and Methods:In this prospective double-blind study, a total of 96 patients undergoing lumbosacral spine surgery were randomized into three groups to receive 25 ml of preemptive caudal epidural injection of either injection ropivacaine 0.2% (Group A, n = 32), a 25 ml of injection ropivacaine 0.2%, and intravenous injection dexamethasone 8 mg (Group B, n = 32) or 25 ml mixture of injection ropivacaine 0.2% with injection dexamethasone 8 mg (Group C, n = 32) under general anesthesia. Visual analog scale (VAS), heart rate, blood pressures, blood sugar levels, and time to rescue analgesia were recorded at regular intervals for the first 24 h. Time to discharge was noted. Analysis of variance has been used to find the significance of study parameters between the groups of patients. Statistical software, namely, SAS 9.2 and SPSS 15.0, have been used for the analysis of the data.Results:The mean VAS was significantly lower in the Group C for up to 24 h following the caudal block. No significant hemodynamic changes were noted in any of the groups. The intravenous dexamethasone group showed higher blood glucose levels at 24 h but was not clinically relevantConclusion:These results suggest that injection dexamethasone is a safe adjunct to caudal ropivacaine in lumbosacral spine surgeries.

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INTRODUCTIONThe World Health Organization has characterized "workrelated" diseases as multi-factorial to indicate that a number of risk factors (e.g., physical, work organizational, psychosocial, individual, and sociocultural) contribute to causing these diseases. 1 Other factors include poor positioning, genetic predisposition, mental stress, physical conditioning and age-related degeneration. [2][3][4] The term-Musculoskeletal Disorders (MSDs)-refers to conditions that involve the nerves, tendons, muscles and supporting structures of the body. There is strong evidence that extreme posture during work and high levels of static contraction cause neck pain. There is also some evidence to suggest repetitive movements cause neck pain, shoulder pain and hand and wrist disorders. 5 Dentists are prone for musculoskeletal disorders especially neck and back pain owing to the following risk factors as a part of their practice-repetitive movements, maintenance of awkward body postures for a long time-ABSTRACT Background: Dentists are prone for chronic pain especially neck and back pain owing to the following risk factors as a part of their practice-repetitive movements, maintenance of awkward body postures for a long time and tasks that require fine motor skills and close visual focus. The term -Musculoskeletal Disorders (MSDs), which result from poor ergonomics, refers to conditions that involve the nerves, tendons, muscles and supporting structures of the body. Methods: 248 dentists in Bangalore were asked to respond to a questionnaire about their practice pattern (years of practice, hours of work, specialization, two-handed/four handed dentistry, use of magnifications etc), their general lifestyle including exercise, fitness patterns, prevalence of MSDs and their general awareness regarding MSDs. The responses were analyzed using descriptive statistics, univariate analysis and Chi-square tests. Results: In our study 95.16% (n=236) and 90.32% (n=224) respondents reported MSDs in the past and in the previous 12 months of the study respectively. 54.84% (n=136) reported at least one episode of backache, 51.61% (n=128) reported neck pain, 19.35% (n=48) reported pain in the shoulder and 32.25% (n=80) reported pain in the wrist and/or hand in the previous 12 months. Our study found considerable influence of the hours of work, use of assistant and magnification on Backache, Neck pain and wrist/hand pain. Conclusions: Work-related pain being common and multifactorial, any possible solution should also be multifactorial and can be managed effectively using a multifaceted approach and the strategies for prevention and care are also discussed.