Adding dexamethasone to intrathecal bupivacaine 0.5%; comparing the anesthetic ability with bupivacaine 0.5% alone among cesarean section patients
DOI:
https://doi.org/10.26641/2307-0404.2022.2.260256Ключевые слова:
dexamethasone, bupivacaine, anesthesia, cesarean sectionАннотация
A perfect anesthesia technique is one in which anesthesia can be done in the shortest possible time with minimal hemodynamic changes and side effects This study is aimed to investigate the effects of concomitant administration of dexamethasone with bupivacaine on the duration of anesthesia and the quality of anesthesia-induced in patients undergoing cesarean section. This is a quasi-experimental study done on patients undergoing cesarean section by spinal anesthesia. All patients underwent standard monitoring after admission, then Ringer serum (5 cc/kg) was administered to the patients. The patients was then seated and subjected to intrathecal anesthesia with a midline approach in L3-L4 space. Patients were matched for baseline conditions. After recording background information, type and dosage of drugs used, blood pressure, heart rate, number and frequency of nausea and vomiting were listed in the checklist, and the data were analyzed using SPSS software. In this study, 70 pregnant women who were candidates for cesarean section were included. All our studied parameters, including the mean time to the start of analgesia, mean time of analgesia duration, analgesia duration, mean time to first request for analgesics were significantly improved among the intervention group. The use of dexamethasone and bupivacaine to induce spinal anesthesia during cesarean section can significantly shorten the onset time of analgesia and reduce postoperative nausea and vomiting. Dexamethasone can be used as an effective drug in cesarean section.
Библиографические ссылки
Edomwonyi NP, Osazuwa MO, Iribhogbe OI, Esangbedo SE. Postoperative analgesia using bupivacaine wound infiltration with intravenous tramadol or dexamethasone following obstetric spinal anaesthesia. Nigerian journal of clinical practice. 2017;20(12):1584-9.
Lavender T, Hofmeyr GJ, Neilson JP, et al. Caesarean section for non-medical reasons at term. Cochrane Database Syst Rev. 2012;(3):CD004660. doi: https://doi.org/10.1002/14651858.CD004660.pub3
Wang X, Hellerstein S, Hou L, et al. Caesarean deliveries in China. BMC Pregnancy Childbirth. 2017;17. doi: https://doi.org/10.1186/s12884-017-1233-8
Hellerstein S, Feldman S, Duan T. China’s 50% caesarean delivery rate: is it too high? BJOG. 2015;122:160-4.
doi: https://doi.org/10.1111/1471-0528.12971
Gupta R, Verma R, Bogra J, Kohli M, Raman R, Kushwaha JK. A comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to bupivacaine. J Anaesthesiol Clin Pharmacol. 2011;27:339-43. doi: https://doi.org/10.4103/0970-9185.83678
Shin YD, Park SH, Kim HT, et al. The effect of anesthesia technique on caesarean section. Pak J Med Sci. 2016;32:147-50. doi: https://doi.org/10.12669/pjms.321.9028
Hoda MQ, Saeed S, Afshan G. Haemodynamic effects of intrathecal Bupivacaine for surgical repair of hip fracture. J Pak Med Assoc. 2007 May;57(5):245-8.
Unal D, Ozdogan L, Ornek HD, Sonmez HK, Ayderen T, Arslan M, et al. Selective spinal anesthesia with low-dose Bupivacaine and Bupivacaine + fentanyl in ambulatory arthroscopic knee surgery. J Pak Med Assoc. 2012 Apr;62(4):313-8.
Kobayashi Y. Effect of adding phenylephrine on spinal anesthesia with tetracaine in elderly patients. Masui. 2012 Jun;61(6):579-82.
Smith KN, Kopacz DJ, Mc Donald SB. Spinal 2- chloroprocaine: a dose-ranging study and the effect of added epinephrine. Anesth Analg. 2004 Jan;98(1):81- 8ю doi: https://doi.org/10.1213/01.ANE.0000093361.48458.6E
Kim WH, Ko JS, Ahn HJ, Choi SJ, Shin BS, Gwak MS, et al. Epinephrine decreases the dose of hyper-baric Bupivacaine necessary for tourniquet pain blockade during spinal anesthesia for total knee replacement arthroplasty. J Anesth. 2012 Aug:22 doi: https://doi.org/10.1007/s00540-012-1471-x
Van Tuijl I, Giezeman MJ, Braithwaite SA, Hen-nis PJ, Kalkman CJ, Van Klei WA. Intrathecal low-dose hyperbaric bupivacaine-clonidine combination in outpatient knee arthroscopy: a randomized controlled trial. Acta Anaesthesiol Scand. 2008 Mar;52(3):343-9. doi: https://doi.org/10.1111/j.1399-6576.2007.01574.x
Ishaque M, Siddiqi R, Hashmi SN, Naseem A, Sabir G, Ikram M. A study of post operative analgesia and adverse effects produced by intrathecal Neostigmine, Morphine and their combination in patients undergoing elective Cesarean Section under Spinal Anesthesia. Pak Armed Forces Med J. Jun 2005;55(2):116-21.
Cormack JR, Orme RM, Costello TG. The role of alpha2-agonists in neurosurgery. J Clin Neurosci. 2005;12:375-8. doi: https://doi.org/10.1016/j.jocn.2004.06.008
Bani-Hashem N, Hassan-Nasab B, Pour EA, Ma-leh PA, Nabavi A, Jabbari A. Addition of intrathecal Dexamethasone to Bupivacaine for spinal anesthesia in orthopedic surgery. Saudi J Anaesth. 2011 Oct;5(4):382-6. doi: https://doi.org/10.4103/1658-354X.87267
Dyer RA, Joubert IA. Low-dose spinal anae-sthesia for Caesarean section. Curr Opin Anaesthesiol. 2004;17(4):301-8. doi: https://doi.org/10.1097/01.aco.0000137088.29861.64
Fayyaz MA, Khan AA, Ali RL. Comparison between effect of bupivacaine and bupivacaine with dexamethasone on duration of analgesia in spinal anaesthesia for elective caesarean section. PJMHS. 2015 Jul 1;9:979-82.
Kim YJ, Lee GY, Kim DY, Kim CH, Baik HJ, Heo S. Dexamathasone added to levobupivacaine impro-ves postoperative analgesia in ultrasound guided inter-scalene brachial plexus blockade for arthroscopic shoulder surgery. Korean J Anesthesiol. 2012 Feb;62(2):130-4. doi: https://doi.org/10.4097/kjae.2012.62.2.130
Vieira PA, Pulai I, Tsao GC, Manikantan P, Kel-ler B, Connelly NR. Dexamethasone with bupivacaine increases duration of analgesia in ultrasound-guided interscalene brachial plexus blockade. European Journal of Anaesthesiology. EJA. 2010 Mar 1;27(3):285-8. doi: https://doi.org/10.1097/EJA.0b013e3283350c38
Cummings III KC, Napierkowski DE, Parra-San-chez I, Kurz A, Dalton JE, Brems JJ, Sessler DI. Effect of dexamethasone on the duration of interscalene nerve blocks with ropivacaine or bupivacaine. British journal of anaesthesia. 2011 Sep 1;107(3):446-53. doi: https://doi.org/10.1093/bja/aer159
Naghipour BA, Aghamohamadi DA, Azarfarin R, Mirinazhad M, Bilehjani EI, Abbasali D, Golzari SE. De-xamethasone added to bupivacaine prolongs duration of epidural analgesia. Middle East J Anesthesiol. 2013 Feb 1;22(1):53-7.
Aga A, Abrar M, Ashebir Z, Seifu A, Zewdu D, Teshome D. The use of perineural dexamethasone and transverse abdominal plane block for postoperative anal-gesia in cesarean section operations under spinal ane-sthesia: an observational study. BMC anesthesiology. 2021 Dec;21(1):1-8.
doi: https://doi.org/10.1186/s12871-021-01513-4
Gupta A, Gupta A, Yadav N. Effect of dexame-thasone as an adjuvant to ropivacaine on duration and quality of analgesia in ultrasound-guided transversus abdominis plane block in patients undergoing lower seg-ment cesarean section-A prospective, randomised, single-blinded study. Indian journal of anesthesia. 2019 Jun;63(6):469. doi: https://doi.org/10.4103/ija.IJA_773_18
Asad MV, Khan FA. Effect of a single bolus of dexamethasone on intraoperative and postoperative pain in unilateral inguinal hernia surgery. J Anaesthesiol Clin Pharmacol. 2015;31:339-43. doi: https://doi.org/10.4103/0970-9185.161669
Cummings KC, 3rd, Napierkowski DE, Parra-Sanchez I, Kurz A, Dalton JE, Brems JJ, et al. Effect of dexamethasone on the duration of interscalene nerve blocks with ropivacaine or bupivacaine. Br J Anaesth. 2011;107:446-53. doi: https://doi.org/10.1093/bja/aer159
Desmet M, Braems H, Reynvoet M, Plasschaert S, Van Cauwelaert J, Pottel H, et al. I.V. and perineural dexamethasone are equivalent in increasing the analgesic duration of a single-shot interscalene block with ropivacaine for shoulder surgery: A prospective, randomized, placebo-controlled study. Br J Anaesth. 2013;111:445-52. doi: https://doi.org/10.1093/bja/aet109
Jehan MK, Abdel-Halim MD. The effect of preo-perative single shot dose of epidural magnesium sulphate or dexamethasone as adjuvants to local anesthesia. Ain Shams J Anaesthesiol. 2011;4-3:83-91.
Abdelmonem A, Rizk SN. Comparative study between intravenous and local dexamethasone as adjuvant to bupivacaine in perianal block. Egypt J Anaesth. 2011;27:163-8. doi: https://doi.org/10.1016/j.egja.2011.04.006
Jain R, Dua CK. Comparative analgesic efficacy of different doses of dexamethasone during infraumbilical surgery: A Randomized controlled trial. Anesth Essays Res. 2015;9:34-8. doi: https://doi.org/10.4103/0259-1162.150153
Shalu PS, Ghodki PS. To study the efficacy of intravenous dexamethasone in prolonging the duration of spinal anesthesia in elective cesarean section. Anesthesia, essays and researches. 2017 Apr;11(2):321. doi: https://doi.org/10.4103/0259-1162.194537
Parveen S, Athaluri VV, Lakshmi BS. Effect of intravenous dexamethasone in prolonging the duration of supraclavicular brachial plexus block with 0.5% ropi-vacaine: A prospective, randomized, placebo controlled study. Int J Sci Study. 2015;2:56-60.
Загрузки
Опубликован
Как цитировать
Выпуск
Раздел
Лицензия
Copyright (c) 2022 Medicni perspektivi
Это произведение доступно по лицензии Creative Commons «Attribution» («Атрибуция») 4.0 Всемирная.
Submitting manuscript to the journal "Medicni perspektivi" the author(s) agree with transferring copyright from the author(s) to publisher (including photos, figures, tables, etc.) editor, reproducing materials of the manuscript in the journal, Internet, translation into other languages, export and import of the issue with the author’s article, spreading without limitation of their period of validity both on the territory of Ukraine and other countries. This and other mutual duties of the author and all co-authors separately and editorial board are secured by written agreement by special form to use the article, the sample of which is presented on the site.
Author signs a written agreement and sends it to Editorial Board simultaneously with submission of the manuscript.