Epidural dexamethasone and ropivacaine for postoperative analgesia in patients of carcinoma rectum undergoing lower anterior resection (LAR)
Background and Aims: This prospective, randomized, double blind study was undertaken to establish the effect of addition of dexamethasone as an adjunct to epidural ropivacaine in patients of carcinoma rectum undergoing lower anteriorresection.
Materials and Methods: Sixty ASA (American Society of Anesthesiologists) class I and II patients undergoing lower anterior resection were enrolled to receive either 6mg or 8mg or 10mg of dexamethasone along with epidural ropivacaine to a total of 10ml test solution in each group for epidural analgesia. Hemodynamic parameters, postoperative analgesia, total requirement of rescue analgesia and adverse events were monitored.
Results: Analgesia in the postoperative period was better in Group receiving 10mg of dexamethasone associated with less postoperative rescue analgesic consumption
Conclusion: Hence, addition of dexamethasone 10mg to epidural ropivacaine can be advantageous with respect to better postoperative analgesia.
patients to postoperative analgesia:Anaesthesia, 1994; 49: 755-58.
2. Abram SE, Marsala M, Yaksh TL: Analgesic and neurotoxic effects of intrathecal corticosteroids in
3. Ebersberger A, Grubb BD, Willingale HL, Gardiner NJ, Nebe J, Schaible HG: The intraspinal release of
prostaglandin E2 in a model of acute arthritis is accompanied by an up-regulation of cyclooxygenase-2 in
the spinal cord: Neuroscience, 1999;93:775–781.
4. Dräger C, Benziger D, Gao F, Berde CB. Prolonged intercostal nerve blockade in sheep using
controlledrelease of bupivacaine and dexamethasone from polymer microspheres.
5. Kopacz DJ, Lacouture PG, Wu D, Nandy P,Swanton R, Landau C. The dose response and effects of
dexamethasone on bupivacaine microcapsules for intercostals blockade(T9toT11) in healthy
6. Movafegh A , Razazian M, Hajimaohamadi F, Meysamie A. Dexamethasone added to lidocaine prolongs
axillary brachial plexus blockade.AnesthAnalg,2006;102:263–267.
7. Vieira PA, Pulai I, Tsao GC, Manikantan P, Keller B, Connelly NR. Dexamethasone with bupivacaine
increases duration of analgesia in ultrasound-guided interscalene brachial plexus blockade.
8. Parrington SJ, O’Donnell D, Chan VWS, Brown-Shreves D, Subramanyam R, Qu M,etal. Dexamethasone
added to mepivacaine prolongs the duration of analgesia after supraclavicular brachial plexus blockade.
Reg Anesth Pain Med,2010;35:422–426.
9. Biradar PA, Kaimar P, Gopalakrishna K. Effect of dexamethasone added to lidocaine in supraclavicular
brachial plexus block: a prospective,randomised,double-blindstudy. IndianJAnesth,2013;57:180–184.
10. Ju NY, Cui GX, GaoW. Ropivacaine plus dexamethasone infiltration reduce spostoperative pain after
tonsillectomy and adenoidectomy. Int J Pediatr Otorhinolaryngol, 2013;77:1881–1885.
11. Thomas S, Beevi S. Epidural dexamethasone reduces postoperative pain and analgesic requirements.Can J
12. Khafagy HF , Refaat AI ,El-Sabae HH, Youssif MA. Efficacy of epidural dexamethasone versus fentanyl
on postoperative analgesia.JAnesth,2010;24(4):531
13. Jo YY, Yoo JH, Kim HJ, KilHK. The effect of epidural Administration of dexamethasone on postoperative
pain:a randomized controlled study in radical subtotal gastrectomy. KoreanJAnesthesiol,2011;61:233–237.
14. Naghipour B, Aghamohamadi D, Azarfarin R, Mirinazhad M, Bilehjani E, Abbasali D,et al.
Dexamethasone added to Bupivacaine prolongs duration of epidural analgesia. Middle East J
15. Eberhart LH, Morin AM, Georgieff M. Dexamethasone for prophylaxis of postoperative nausea and
vomiting. A meta analysis of randomized controlled studies. Anesthesist2000;49:713–720.
16. Gan TJ, Meyer T, Apfel CC, Chung F, Davis PJ, Eubanks S, et al. Consensus guidelines for managing post
operative nausea and vomiting. Anesth Analg,2003;97:62–71.
17. DeOliveira GS Jr, Castro-Alves LJ, Ahmad S, Kendall MC, McCarthy RJ. Dexamethasone to prevent
postoperative nausea and vomiting: an updated meta-analysis of randomized controlled trials. Anesth
18. Wang YL, Tan PP, Yang CH, Tsai SC, Chung HS. Epidural dexamethasone reduces the incidence of
backache after lumbar epidural anesthesia. AnesthAnalg,1997;84:376-8.
19. Maillefert JF, Aho S, Huguenin MC, Chatard C, Peere T, Marquignon MF, Lucas B, Tavernier C.
Systemic effects of Epidural dexamethasone injections. Rev Rhum Eng lEd. 1995,Jun;62(6):429-32.
20. Wang YL, Tan PP, Yang CH, Tsai SC, Chung HS. Epidural dexamethasone reduces the incidence of
backache after lumbar epidural anesthesia.AnesthAnalg,1997;84:376-8.
Copyright©2017 SKIMS Soura