Abebe Minda, Alemu Belete, Teku Gudeta, Eshetu Oliyad, Wale Endeshaw, Besha Aschalew, Kebede Mengistu Yinges, Geta Lamesgen
Department of Anesthesia, Collage of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
Department of Anesthesia, Collage of Medicine and Health Sciences, Debremarkos University, Debremarkos, Ethiopia.
J Pain Res. 2024 Apr 5;17:1361-1368. doi: 10.2147/JPR.S451595. eCollection 2024.
The analgesic effectiveness of a single perioperative dose of dexamethasone is not clearly defined. The administration of systemic medication like dexamethasone, opioids, and non-steroidal anti-inflammatory drugs has a positive effect on the prolongation of postoperative analgesia after cesarean section under spinal anesthesia. A single-dose administration of dexamethasone with moderate to high dose reduces postoperative pain, reduces opioid consumption, and prolongs spinal anesthesia after cesarean delivery.
The aim of this systematic review was to investigate the effectiveness of single intravenous dexamethasone in prolongation of spinal anesthesia for postoperative analgesia in elective cesarean section.
We conducted a search on PubMed, Google Scholar, the Cochrane Library, Hinari, and review articles on the effectiveness of intravenous dexamethasone for extending spinal anesthesia during elective cesarean sections, until June 2023. The searches were conducted by using keyword (IV dexamethasone OR/AND analgesia OR postoperative pain AND cesarean section OR child birth AND prolongation of spinal anesthesia). The articles included describe the analgesic efficacy of dexamethasone for prolongation of spinal anesthesia during cesarean section.
A total of 25,384 papers were found using different searching methodologies from different electronic databases. The EndNote reference manager was used to remove duplicates, and 438 articles were selected for screening. Of those, 57 were included for critical evaluation, and 49 were removed with justification. The effectiveness of IV dexamethasone on the prolongation of spinal anesthesia and postoperative analgesia in women undergoing cesarean delivery is the subject of eight RCT studies on 628 parturients that are presented in the chosen journal articles from various countries.
Intravenous dexamethasone administration immediately after clamping of the umbilical cord prolongs the duration of spinal block in patients undergoing cesarean sections and has a significant impact on reduction of postoperative pain severity, opioid consumption, and other pain requirements. When high-dose dexamethasone is administered intravenously, it can overcome complications that may arise after severe pain and increase patient satisfaction by extending the duration of postoperative analgesia and sensory block.
围手术期单次使用地塞米松的镇痛效果尚不明确。使用地塞米松、阿片类药物和非甾体抗炎药等全身性药物对脊麻下剖宫产术后镇痛的延长有积极作用。剖宫产术后单剂量给予中高剂量地塞米松可减轻术后疼痛、减少阿片类药物用量并延长脊麻时间。
本系统评价旨在研究单次静脉注射地塞米松对择期剖宫产术后镇痛中延长脊麻时间的有效性。
我们在PubMed、谷歌学术、Cochrane图书馆、Hinari以及关于静脉注射地塞米松在择期剖宫产术中延长脊麻有效性的综述文章中进行检索，检索截至2023年6月。检索使用关键词（静脉注射地塞米松或/和镇痛或术后疼痛以及剖宫产或分娩以及脊麻延长）。纳入的文章描述了地塞米松在剖宫产术中延长脊麻的镇痛效果。
使用不同的检索方法从不同电子数据库共检索到25384篇论文。使用EndNote参考文献管理软件去除重复项，筛选出438篇文章。其中，57篇纳入进行严格评价，49篇经论证后被排除。静脉注射地塞米松对剖宫产妇女延长脊麻时间和术后镇痛的有效性是来自不同国家的所选期刊文章中8项针对628名产妇的随机对照试验研究的主题。
脐带结扎后立即静脉注射地塞米松可延长剖宫产患者的脊麻时间，并对降低术后疼痛严重程度、减少阿片类药物用量及其他疼痛需求有显著影响。静脉注射高剂量地塞米松可克服严重疼痛后可能出现的并发症，并通过延长术后镇痛和感觉阻滞时间提高患者满意度。
