The analgesic efficacy of intravenous dexamethasone for post-caesarean pain

Abstract

The analgesic efficacy of intravenous dexamethasone has not been well defined after caesarean delivery. We conducted a meta-analysis to evaluate the impact of dexamethasone on pain after caesarean delivery in comparison to nonactive control. Dexamethasone was associated with significant reduction in resting pain scores, and prolonged time to first analgesia. Trial sequential analysis suggested the benefit for early pain scores and time to first analgesia. However; requisite information size was only available for the latter.

PROSPECT guideline for elective caesarean section: an update

“…In the trial by Edomwonyi et al [7] intravenous tramadol was compared with intravenous dexamethasone, and the fact that an analgesic adjuvant (dexamethasone) can achieve similar analgesia when compared with a potent analgesic such as tramadol is in itself a strong result.…”

“…The systematic review [7] included three of the four trials mentioned above [3–5] and an additional 10 trials. No trials utilised neuraxial diamorphine and only three trials utilised neuraxial morphine.…”

“…The original guidelines recommended the use of dexamethasone on the basis of four trials [3][4][5][6] and this recommendation was graded as Grade A. The recent guidelines strengthened the recommendations because of a more recent systematic review [7]. Taking the four trials in order, I believe there are deficiencies in them that I wish to explore.…”

“…The systematic review [7] included three of the four trials mentioned above [3][4][5] and an additional 10 trials.…”

PROSPECT guideline for elective caesarean section: an update

“…First, the recommendation on the benefits of dexamethasone is reinforced. Indeed, a systematic review [2] confirm our recommendation of administering a single dose of dexamethasone. Intravenous dexamethasone was associated with reduced pain scores, longer times to first analgesic request and reduced rescue opioid consumption.…”