Open AccessEfficacy of Different Doses of Dexamethasone as Pre-emptive Analgesia in Patients Undergoing Total Abdominal Hysterectomy under General Anaesthesia: A Prospective Non Randomised Placebo Controlled Study
Author(s) -
Preeti Sharma,
Shaista Yaqoob,
Waqar- UL-Neesa
Publication year - 2021
Publication title -
journal of clinical and diagnostic research
Language(s) - English
Resource type - Journals
eISSN - 2249-782X
pISSN - 0973-709X
DOI - 10.7860/jcdr/2021/50086.15581
Subject(s) - medicine , dexamethasone , anesthesia , analgesic , nausea , vomiting , placebo , postoperative nausea and vomiting , hysterectomy , general anaesthesia , visual analogue scale , adverse effect , surgery , alternative medicine , pathology
Pre-emptive analgesia reduces postoperative analgesic requirement, avoiding side-effects that occur with parenteral narcotics. Dexamethasone, a long acting synthetic corticosteroid with predominantly glucocorticoid activity is one of the entities used for pre-emptive analgesia. The optimum dose of dexamethasone for pre-emptive analgesia is not defined. Aim: To study the efficiency of different (low, intermediate and high) doses of dexamethasone as pre-emptive analgesia in patients undergoing total abdominal hysterectomy under general anaesthesia. Materials and Methods: The prospective non randomised placebo controlled dose range study was conducted in the Department of Anaesthesiology, at a tertiary care institute at Srinagar, Jammu and Kashmir, India, over a period of two years from July 2017 to June 2019. Eighty female patients (age 40-65 years, American Society of Anaesthesiologists (ASA) I and II) scheduled for total abdominal hysterectomy were divided into four groups (Groups A, B, C and D) on the basis of dexamethasone dose. Group A with low dose (0.1 mg/kg), group B with intermediate dose (0.12-2 mg/ kg), group C with high dose (>0.2 mg/Kg) and group D with no dexamethasone. Early and late acute postoperative pain {Visual Analog Scale (VAS) score}, cumulative analgesic consumption upto 24 hours, intraoperative blood sugar levels, Postoperative Nausea and Vomiting (PONV), and adverse events were recorded. Analysis of variance (ANOVA) was used for intergroup comparison of means and Chi-square test was used for categorical variables. Results: The mean age (years) of group A was 52.3±8.87, group B was 48.3±5.23, group C was 49.8±6.85 and group D was 51.7±4.46. Postoperative VAS score for 0 hour, 1 hour, 2 hour, 3 hour, 4 hour was more in patients who had not received dexamethasone pre-emptively (p-value 0.05). Conclusion: Intermediate and high dose dexamethasone, given preoperatively in patients undergoing abdominal hyster-ectomy produces better postoperative analgesia with added antiemetic benefit.