Implants médicaux et chirurgie

Abstrait

Can a single dose of intravenous dexamethasone improve post caesarean delivery analgesia?

T Dessain, S Tahir, D Dabrowska

Background: Single dose of intravenousdexamethasone has been shown to improve post operative analgesia in obstetric patients Our aim was to establish if a single dose of dexamethasone would improve pains cores and reduce opioid consumptionas part of multimodalanalgesic regime. Methods : Over a 6 monthperiod data wascollected for 34 patientsundergoingelective C-section. A control group received standardised CSE and intraoperativeanalgesics The intervention group received an additional single dose of intravenous 6.6mg dexamethasone (n=20). Post operatively patients received standardised analgesia and were reviewed the followingday.  Primary out comes were post operative opioid consumption and subjectivepain score using VAS. Results: Patients receiving dexamethas one showed significantly lower pain scores on the first postoperative day ((median (IQR) − 2.5 (1 - 4)) compared to the control group (median (IQR) - 6 (5 - 7)), p=0.001 with no side-effects. Therewas no benefit of dexamethasone on the averagehourlyopioidconsumption ((median (IQR) − 1.125mg/hr (0 - 1.8mg/hr)) compared to the control group ((median (IQR) - 0.65mg/hr (0 - 1.25mg/hr)), p=0.516. Conclusions: IV Dexamethasoneis a safe non-opiate adjunctwhichreducedpostoperativepainscores and shouldconsideredduring C-sections.