Preoperative dexamethasone and intraperitoneal bupivacaine for postoperative pain relief

Abstract

Introduction: Remarkable advancement in managing post-operative pain is made using various analgesics. Dexamethasone is a potent anti-inflammatory, analgesic, and anti-emetic agent and readily available, easy to administer, and a safe adjunct for postoperative analgesia. The intraperitoneal use of local anesthetics is known to improve postoperative pain. The present study is aimed to assess the effectiveness of preoperative dexamethasone combined with intra-peritoneal bupivacaine for postoperative pain relief.

Objective: To assess the effectiveness of preoperative Dexamethasone combined with intra-peritoneal Bupivacaine for postoperative pain relief following surgery.

Material and Methods: A prospective, randomized controlled study was done over a period of one year on 172 women scheduled for elective gynecological surgeries. The study group received Dexamethasone 8mg IV, 5 minutes prior to induction of anesthesia or before surgical incision, and intra-operatively 30ml of 0.25% Bupivacaine intraperitoneally under aseptic precautions. The control group received standard anesthesia as per the routine hospital protocol. Postoperatively patients monitored for vitals, pain assessment using Visual Analogue Score. The severity of postoperative nausea and vomiting (PONV) was evaluated. After a 24-hour assessment period, patients were asked to make an overall rating of satisfaction with post-operative pain relief on a verbal response (VReS).

Results: It was noted that the mean consumption of analgesic doses was significantly high in group B compared to group A (3.01±0.52 vs 1.46±0.83; p<0.001).The mean VRes scores in group A were significantly high compared to group B (2.95±1.01 vs 0.20±0.51; p<0.001).

Conclusion: Dexamethasone combined with intra-peritoneal Bupivacaine is highly effective in reducing postoperative pain along with PONV.