Vasan Nikitha, Kumar Meenakshi, Guria Sushil, Verma Krishika, Choudhary Renuka
Anesthesiology, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, IND.
Anesthesiology and Critical Care, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, IND.
Cureus. 2024 Dec 3;16(12):e75020. doi: 10.7759/cureus.75020. eCollection 2024 Dec.
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.
引言 下段剖宫产术后有效的镇痛对于促进手术恢复和增进母婴情感联结至关重要。本研究旨在比较两种静脉注射地塞米松剂量（8毫克和4毫克）对下段剖宫产患者术后疼痛的管理效果。目的是评估4毫克剂量是否能提供与8毫克剂量相当的疼痛缓解效果，以确定有效疼痛管理且副作用最小的最佳剂量。方法 本前瞻性、随机、干预性对照研究针对70例在蛛网膜下腔麻醉下行下段剖宫产的产妇进行。参与者被随机分为两组，每组35例。A组静脉注射8毫克地塞米松，而B组在胎儿娩出后静脉注射4毫克。两组均在术后24小时内每6小时测量一次视觉模拟评分（VAS）、首次补救镇痛时间、24小时内补救镇痛药物总消耗量、感觉和运动阻滞持续时间、术后恶心呕吐（PONV）发生率以及血糖水平。结果 结果显示，A组的VAS评分显著低于B组（p < 0.05）。然而，两组的PONV发生率和感觉及运动阻滞持续时间相似（p > 0.05）。A组在所有时间点的血糖水平均较高（p < 0.05）。结论 对于在蛛网膜下腔麻醉下行下段剖宫产的患者，4毫克剂量的地塞米松似乎是比8毫克剂量更好的术后镇痛选择。它与较低的平均VAS评分、较低的PONV发生率以及较小的血糖水平升高相关。
