Comparison of local and intra venous dexamethasone on post operative pain and recovery after caeseream section. A randomized controlled trial

Maged, Ahmed M.; Deeb, Wesam S.; Elbaradie, Sahar M Y; Elzayat, Ahmed R.; Metwally, Ahmed A.; Hamed, Mohamed Ahmed; Shaker, Ahmed

doi:10.1016/j.tjog.2018.04.004

Cited by 34 publications

(60 citation statements)

References 19 publications

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“…Responding to VAS by selecting the degree of agreement to a statement like pain sensation by along a continuous line between two endpoints where zero end reflects no pain and 10 end means maximum pain sensation. A VAS score of 0 indicated no pain and a score of 10 indicated the worst possible pain . VAS was also used to assess difficulty experienced by the operator where a score of 0 indicated no difficulty at all and a score of 10 indicated the most difficult procedure.…”

Section: Methodsmentioning

confidence: 99%

RETRACTED: The value of endocervical and endometrial lidocaine flushing before office hysteroscopy: A randomized controlled trial

Shoab

Maged

Ramadan

et al. 2019

Intl J Gynecology & Obste

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Objective To evaluate the safety and efficacy of flushing the cervical canal and the uterine cavity with local anesthetic in order to reduce the pain felt by patients during office hysteroscopy. Methods A double‐blind randomized controlled trial was conducted between May 1, 2018, and February 28, 2019, involving 260 women undergoing office hysteroscopy at Kasr Al Ainy Hospital, Cairo, Egypt. Women were randomized using a computerized random number generator to intrauterine and intracervical instillation 5 minutes before the procedure of either 5 mL lidocaine 2% diluted in 15 mL normal saline, or 20 mL normal saline alone. The primary outcome measure was the visual analog scale (VAS) pain score reported by women during the procedure. Secondary outcomes included VAS score at 10 and 30 minutes after the procedure, the need for analgesia, and occurrence of vasovagal attacks. Results Women in the lidocaine flushing group reported a significantly lower VAS score during the procedure (1.8 ± 1.1 vs 5.2 ± 1.8) and 10 and 30 minutes after it (1.3 ± 1.15 and 0.8 ± 0.9 vs 4.3 ± 2.1 and 2.98 ± 1.96) when compared with control women (P<0.001). More women without lidocaine flushing experienced vasovagal attacks (25/130 vs 9/130, P<0.001) and needed analgesia (84/130 vs 13/130, P<0.001) when compared with women with lidocaine flushing. Conclusion Flushing of the cervical canal and uterine cavity with local anesthetic significantly decreased pain sensation in women undergoing office hysteroscopy. ClinicalTrials.gov: NCT03530488

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Section: Methodsmentioning

confidence: 99%

RETRACTED: The value of endocervical and endometrial lidocaine flushing before office hysteroscopy: A randomized controlled trial

Shoab

Maged

Ramadan

et al. 2019

Intl J Gynecology & Obste

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“…Figure gives the result of the literature search identifying 17 studies reporting on 1133 patients. Nine studies used 8 mg i.v.…”

Section: Resultsmentioning

confidence: 99%

“…Nine studies used 8 mg i.v. dexamethasone; 10 mg and 4 mg , were studied in two trials each; a body weight‐adjusted dose of 0.1 mg.kg −1 was studied in three trials and doses of 40 mg and 16 mg were studied in one trial each. Of these studies, one had two comparisons, dexamethasone 8 mg vs. placebo and dexamethasone 4 mg plus 0.625 mg droperidol vs. 1.25 mg droperidol.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Several studies did not indicate whether pain scores were assessed at rest or on movement. Lower pain values were found by the following authors: Parthasarathy from 90 min up to 4 h postoperatively; Kadur at 6 h, 12 h, 18 h and 24 h, but not at 2 h and 4 h; by Jaafarpour at 3 h, 6 h and 24 h; Maged at 1 h, 4 h, 6 h, 12 h, 24 h but not at 30 min. Cardoso et al reported that the number of patients without pain was significantly higher in the dexamethasone group at 6 h (at rest and on movement) and at 24 h (on movement only).…”

Section: Resultsmentioning

confidence: 99%

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Effect of intravenous dexamethasone on postoperative pain after spinal anaesthesia – a systematic review with meta‐analysis and trial sequential analysis

et al. 2019

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There are data suggesting that intravenous dexamethasone has an effect on postoperative analgesia when given during single-shot spinal anaesthesia. However, the research literature is equivocal. We performed a systematic literature search followed by conventional meta-analysis (random effects model). We used trial sequential analysis to control for type-1 and -2 statistical errors. We also performed a leave-one-out metaanalysis for our primary outcome, the consumption of intravenous morphine in the first 24 postoperative hours. We applied the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to rate the level of evidence. We obtained data from 1133 patients, reported in 17 trials. Reporting quality was high, with low risk of bias. Dexamethasone use was associated with a significant reduction in 24-h morphine consumption, the mean difference (95%CI) being À4.01 (À5.01 to À3.01) mg, 6 trials, 326 participants, I 2 = 0%. Trial sequential analysis showed that there was firm evidence for the primary outcome, and leave-one-out metaanalysis showed that our result was not driven by one single trial. The GRADE evaluation showed a high level of evidence, suggesting that further studies are unlikely to alter the result. The time to first analgesic request (95% CI) was significantly prolonged by 86.62 (10.62-162.62) min, I 2 = 93%, in the dexamethasone group. For other secondary outcomes including number of patients requiring rescue analgesia, or visual analogue scale pain scores, we found no evidence of a significant difference between the treatment arms. We report a high level of evidence that intravenous dexamethasone improves postoperative analgesia after spinal anaesthesia.

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Post-cesarean section analgesia

Verstraete

Velde²

2022

Best Practice & Research Clinical Anaesthesiology

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Comparison of local and intra venous dexamethasone on post operative pain and recovery after caeseream section. A randomized controlled trial

Cited by 34 publications

References 19 publications

RETRACTED: The value of endocervical and endometrial lidocaine flushing before office hysteroscopy: A randomized controlled trial

RETRACTED: The value of endocervical and endometrial lidocaine flushing before office hysteroscopy: A randomized controlled trial

Effect of intravenous dexamethasone on postoperative pain after spinal anaesthesia – a systematic review with meta‐analysis and trial sequential analysis

Post-cesarean section analgesia

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