The Efficiency of Intrathecal Dexamethasone for Spinal Anaesthesia in Elective Caesarean Section

Ткаченко, Р.О.; Pyasetska, Nataliya; Petrychenko, V.V.

doi:10.26226/morressier.5d1cc24d57558b317a173628

Cited by 2 publications

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“…It has been shown that the duration of post-operative analgesia was prolonged when dexamethasone was given as an adjunct for peripheral nerve blocks [ 7 ]. We found that a very few studies in the literature reported the intrathecal use of dexamethasone as an adjuvant [ 8 , 9 ]. Hence keeping this in view, we conducted this study to evaluate comparative efficacy of intrathecal dexamethasone, fentanyl and normal saline as adjuvants to hyperbaric bupivacaine in spinal anesthesia administered to patients scheduled for lower limb orthopedic surgery.…”

Section: Introductionmentioning

confidence: 99%

Prospective Randomized Control Trial Comparing Effect of Dexamethasone Versus Fentanyl as Adjuvants to Intrathecal Bupivacaine for Orthopedic Surgery

Kaur¹,

Misra²,

Mittal³

et al. 2021

Cureus

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IntroductionSpinal anesthesia is the most consistent block for lower limb orthopedic surgeries. We conducted this randomized prospective study to evaluate comparative efficacy of intrathecal dexamethasone with fentanyl and normal saline as adjuvants to hyperbaric bupivacaine in spinal anesthesia administered to patients scheduled for lower limb orthopedic surgery. Materials and methods105 patients scheduled for lower limb orthopedic surgeries under spinal anesthesia were included in this clinical trial. After randomization, patients received an intrathecal injection of hyperbaric bupivacaine (12.5 mg) with 4 mg of dexamethasone in group I, hyperbaric bupivacaine (12.5 mg) with 25 ug fentanyl with 0.5 ml of normal saline in group II and hyperbaric bupivacaine (12.5 mg) with normal saline (1 ml) in group III, so as to make volume of drug equal in all three groups. The observer evaluated the sensory and motor blocks and other parameters like time to self-void, stay in post-anesthesia care unit (PACU) and complications. ResultsThe total duration of sensory blockade was found to be 311. 43, 197.86 and 115.29 minutes and motor blockade of 223.43, 163.86 and 83.0 minutes in groups I, II and III respectively. The PACU stay was 233.14, 173.86 and 93.00 minutes in groups I, II and III, respectively. The average time to self-void was 400.00, 315.29 and 203.00 in three groups, respectively. ConclusionIntrathecal dexamethasone seemed to be an effective adjuvant to spinal bupivacaine as it prolongs the duration of analgesia, stable hemodynamic profile with minimal side effects. Further studies are required to evaluate the optimum dose and long-term safety of intrathecal dexamethasone.

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Section: Introductionmentioning

confidence: 99%

Prospective Randomized Control Trial Comparing Effect of Dexamethasone Versus Fentanyl as Adjuvants to Intrathecal Bupivacaine for Orthopedic Surgery

Kaur¹,

Misra²,

Mittal³

et al. 2021

Cureus

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Comparative Efficacy of Different Classes of Antiemetic Medications for the Prevention of Nausea and Vomiting in Cesarean Section: A Network Meta-Analysis

Asgarlou,

Mohammadian,

Houshmandi

et al. 2023

International Journal of Preventive Medicine

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Background: Antiemetic medications have been associated with the prevention of nausea and vomiting in cesarean section, although less is known about the comparative efficacy of different medication classes. Methods: We conducted a systematic review with network meta-analyses to compare and rank antiemetic medication classes (5-HT3 receptor antagonists, dopamine receptor antagonists, corticosteroids, antihistamines, anticholinergic agents, sedatives, and opioid antagonists or partial agonists) in terms of preventing intra- and postoperative nausea and vomiting among patients undergoing cesarean section. We included all randomized controlled trials (RCTs) that evaluated any antiemetic medication classes’ treatment for target outcomes. Network meta-analysis was conducted with a frequentist approach using the R netmeta package. A total of 58 trials were included (6,665 women undergoing cesarean section; mean age, 28.1 years). Results: Compared with placebo, all interventions reduced the odds of intraoperative nausea (except antihistamines), intraoperative vomiting (except antihistamines), postoperative nausea (except anticholinergic agents and opioid antagonists), and postoperative vomiting (except opioid antagonists). In terms of intraoperative nausea and both intra- and postoperative vomiting, sedatives ranked first among other medication classes. Conclusions: The relative effect sizes for various classes of antiemetic medication in preventing nausea and vomiting in the cesarean section were modeled using the principles of network meta-analysis which may facilitate informed clinical decision-making.

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The Efficiency of Intrathecal Dexamethasone for Spinal Anaesthesia in Elective Caesarean Section

Cited by 2 publications

References 0 publications

Prospective Randomized Control Trial Comparing Effect of Dexamethasone Versus Fentanyl as Adjuvants to Intrathecal Bupivacaine for Orthopedic Surgery

Prospective Randomized Control Trial Comparing Effect of Dexamethasone Versus Fentanyl as Adjuvants to Intrathecal Bupivacaine for Orthopedic Surgery

Comparative Efficacy of Different Classes of Antiemetic Medications for the Prevention of Nausea and Vomiting in Cesarean Section: A Network Meta-Analysis

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