Comparative Evaluation of Two Doses of IV Dexamethasone for Postoperative Analgesia in Patients Undergoing Lower Segment Cesarean Section Under Spinal Anesthesia: A Randomized Controlled Trial.

Introduction Effective postoperative analgesia following lower segment cesarean section (LSCS) is crucial for promoting surgical recovery and fostering maternal-neonatal bonding. This study aimed to compare the efficacy of two IV dexamethasone doses (8 mg and 4 mg) in managing postoperative pain in LSCS patients. The objective was to assess whether the 4 mg dose provides comparable pain relief to the 8 mg dose, with the goal of identifying the optimal dosage for effective pain management with minimal side effects. Methods This prospective, randomized, interventional comparative study was conducted on 70 parturients undergoing LSCS under spinal anesthesia (SA). The participants were randomly assigned into two groups of 35 each. Group A received 8 mg of IV dexamethasone, while Group B received 4 mg intravenously after the delivery of the baby. The Visual Analogue Scale (VAS) score, time to first rescue analgesia, total rescue analgesic consumption within 24 hours, duration of sensory and motor blockade, incidence of postoperative nausea and vomiting (PONV), and blood sugar levels were measured every six hours up to 24 hours post-surgery for both groups. Results The results revealed a significantly lower VAS score in Group A compared to Group B (p < 0.05). However, the incidence of PONV and the duration of sensory and motor blockade were similar between the two groups (p > 0.05). Blood sugar levels were higher in Group A at all time points (p < 0.05). Conclusions The 4 mg dose of dexamethasone appears to be a better alternative for postoperative analgesia compared to the 8 mg dose in patients undergoing LSCS under SA. It was associated with a lower mean VAS score, a reduced incidence of PONV, and a smaller increase in blood sugar levels.