Background: Although ultrasound-guided transversus abdominis plane block (TAPB) is widely used in multimodal analgesia after cesarean delivery (CD), the complications of TAPB during analgesia after CD have rarely been reported. Methods: A total of 84 cases of CD were randomly assigned to either a ropivacaine group (R group) or ropivacaine + dexamethasone group (RD group) in this double-blind trial. The pain site and pain degree at rest and during activity at 2 h, 6 h, 10 h, 12 h, 14 h, 16 h, 20 h, and 24 h after maternal surgery were recorded. The consumption of opioids at 24h, postoperative nausea, vomiting, exhaustion, and other adverse reactions were recorded. Results: A total of 80 patients were included in the analysis of results. A total of 19 patients developed ISP, 14 in the R group and 5 in the RD group. The incidence of ISP in the R and RD groups was 35% and 12.5%, respectively. The results described above showed that combining dexamethasone with ropivacaine reduced the incidence of ISP, and the difference was statistically significant (P<0.05). Two groups of women with positive ISP had higher values of opioid consumption than women with negative ISP, but the difference was not significant. Conclusion: Dexamethasone as an adjuvant for ropivacaine can effectively relieve the ISP of ultrasound-guided TAPB after CD, and can enhance the analgesic effect of ropivacaine.

Background: This meta-analysis was to evaluate the safety and efficiency of dexamethasone for pain relief followed lumbar decompression and fusion.Methods: Two reviewers have independently searched 3 electronic databases (PubMed, EMBASE and Cochrane Library) up to Jun, 2019 without restrictions on language and publication. After testing for heterogeneity between studies, data were aggregated for random-effects models when necessary. The results of dichotomous outcomes were expressed as relative risks (RRs) with a 95% confidence intervals (CIs). For continuous variable, mean and standard difference (SD) were applied for assessment. Meta-analysis was performed using Stata 12.0 software.Results: Seven RCTs and one retrospective study including 958 patients met the inclusion criteria. The present meta-analysis indicated that there were significant differences between groups in terms of visual analogue scale (VAS) scores at 24 hours of movement (SMD=0.44, 95% CI: 0.67 to 0.21, P < 0.001). Dexamethasone group was associated with a lower opioids consumption at 24 hours (SMD=0.601, 95% CI: 0.93 to 0.28, P < 0.001), less occurrence of nausea and vomiting (RR=0.52, 95% CI: 0.40 to 0.67, P < 0.001), shorter length of hospital stay (SMD = 0.207, 95% CI: 0.396 to 0.017, P = 0.003).Conclusion: In our meta-analysis of 8 reliable studies, we found that intravenous dexamethasone could significantly reduce postoperative pain scores and opioids consumption within the 24 hours followed lumbar decompression and fusion. Furthermore, patients could gain functional exercise early and the length of stay in hospital was significantly shorten. More researches were needed to confirm these conclusions.