Local injection of dexamethasone helping to prevent lower back pain after epidural delivery analgesia

Abstract

This report aims to retrospectively analyze the clinical effect of local pretreatment with dexamethasone (DXMS) on lower back pain after epidural labor analgesia. Patients with epidural labor analgesia treated in People's Hospital of Rizhao from January 2014 to December 2016 were studied. All 368 cases involved were pregnant primipara with full-term single birth. Parturient received injection of DXMS and lidocaine mixture around the epidural puncture point was the observation group (n=188), and parturient received injection of 0.9% sodium chloride and lidocaine mixture around the epidural puncture point was the control group (n=180). The incidence and degree of lower back pain postoperatively in the two groups were evaluated by pain visual analogue scale method. The incidence of lower back pain at 48 h, 72 h after operation in observation group was significantly lower than that in control group (p<0.05). Among patients undergoing one puncture and more than one puncture, the incidence of postoperative lower back pain in the observation group was significantly lower than that in the control group (59.26%) (p<0.05). Among the parturient with spontaneous delivery, the incidence of postoperative lower back pain in the observation group was significantly lower than that in the control group (p=0.028). Among the cesarean section patients, the incidence of pain in observation group was significantly lower than that in control group (p=0.019). At 48 and 72 h after operation, severe pain in the observation group was significantly less than that in the control group (p<0.05). DXMS local pretreatment can significantly reduce the incidence of postoperative lower back pain and the degree of pain after epidural delivery analgesia. DXMS pretreatment in epidural analgesia deserved to be widely used clinically.

Epidural Infusion of Dexmedetomidine Improves the Experience of Primiparas Undergoing Cesarean Section with Epidural Anesthesia: A Randomized Double‑Blinded Controlled Study

“…Good anesthetic practice is composed of adequate analgesia, appropriate sedation, satisfying surgical requirements and rare side effect, thus contributes to good patient satisfaction. Nowadays, most cesarean sections are conducted under neuraxial anesthesia of which EA is one of the most popular anesthesia techniques, due to it's simple, well controllable and cost effective (22). However, many parturients (around 45%-90%) didn't get completely analgesia and high comfort during surgery as a possible consequence of incomplete blockade of large nerve roots such as L5, S1 and S2 (5), which may result in serious visceral pain when surgeon's handling intraperitoneal organs or uterine contraction (6).…”

Effect of epidural dexmedetomidine in single-dose combined with ropivacaine for cesarean section

“…Good anesthetic practice is composed of adequate analgesia, appropriate sedation, satisfying surgical requirements and rare side effect, thus contributes to good patient satisfaction. Nowadays, most cesarean sections are conducted under neuraxial anesthesia of which EA is one of the most popular anesthesia techniques, due to it’s simple, well controllable and cost effective [ 23 ]. However, many parturients (around 45-90%) didn’t get completely analgesia and high comfort during surgery as a possible consequence of incomplete blockade of large nerve roots such as L5, S1 and S2 [ 5 ], which may result in serious visceral pain when surgeon’s handling intraperitoneal organs or uterine contraction [ 6 ].…”