The effect of addition of dexamethasone to levobupivacaine in parturients receiving combined spinal-epidural for analgesia for vaginal delivery

Abstract

Background and Aims:Regional analgesia is commonly used for the relief of labour pain, Prolongation of analgesia can be achieved by adjuvant medications. The aim of this randomised controlled trial was to evaluate the efficacy of intrathecal levobupivacaine with dexamethasone for labour analgesia.Methods:A total of 80 females were included in this study, all were primigravidas undergoing vaginal delivery with cervical dilatation ≥4 cm and 50% or more effacement. Forty females were included randomly in either Group L (received intrathecal levobupivacaine 0.25% in 2 mL) or Group LD (received intrathecal levobupivacaine 0.25% combined with dexamethasone 4 mg in 2 mL). The primary outcome was the duration of spinal analgesia. Secondary outcomes included the total dose of epidural local anaesthetic given, time to delivery, neonatal outcome and adverse effects.Results:The duration of spinal analgesia was significantly longer in the LD group compared with L group (80.5 ± 12.4 min vs. 57.1 ± 11.5 min, respectively; P < 0.001). In Group LD compared with Group L, time from spinal analgesia to delivery was significantly lower (317.4 ± 98.9 min vs. 372.4 ± 118.8 min, respectively; P = 0.027), and total epidural levobupivacaine consumption was significantly lower (102.4 ± 34.8 mg vs. 120.1 ± 41.9 mg, respectively; P = 0.027). The two groups were comparable with respect to characteristics of sensory and motor block, haemodynamic parameters, pain scores, neonatal outcome and frequency of adverse effects.Conclusion:Intrathecal dexamethasone plus levobupivacaine prolongs the duration of spinal analgesia during combined spinal-epidural CSE for labour analgesia.

Can Epidural Dexamethasone Reduce Patient-Controlled Epidural Consumption of Fentanyl and Levobupivacaine in Laboring Women? A Double-Blind, Randomized, Placebo-Controlled Trial

“…In two recently published studies from Egypt, using the same control group but adding epidural dexamethasone to either epidural anesthesia or CSEA in laboring parturients, the authors did not find any difference in adverse effects on the mother, fetus or neonate between the control group and the two dexamethasone groups [17,18]. These two studies are the only studies currently directly comparable with ours, in terms of patient groups, study design and procedures.…”

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

“…DXM also has significant preventive effect on postpartum hemorrhage in cesarean section ( 6 ). There are also studies showing that DXMS is conducive for combined spinal-epidural analgesia cesarean section ( 7 ), which indicates that DXMS has been widely used in pregnant women and its safety has been guaranteed. DXMS has a variety of therapeutic effects, but there are few researches about its effect on postoperative epidural analgesia lower back pain.…”