Dexamethasone and Lidocaine Effects in 24 hours Post Cesarean Pain Reduction under Spinal Anesthesia: A Randomized Controlled Trial

Rangsiman Smitasiri; Athita Chanthasenanont; Yanwadee Chitkoolsamphan; Densak Pongrojpaw; Sawanya Benchahong; Komsun Suwannarurk

doi:10.33192/smj.v76i9.268510

Authors

Rangsiman Smitasiri Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathum Thani 12120, Thailand
Athita Chanthasenanont Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathum Thani 12120, Thailand
Yanwadee Chitkoolsamphan Faculty of Medicine, Thammasat University, Pathum Thani 12120, Thailand.
Densak Pongrojpaw Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathum Thani 12120, Thailand
Sawanya Benchahong Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathum Thani 12120, Thailand
Komsun Suwannarurk Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathum Thani 12120, Thailand

DOI:

https://doi.org/10.33192/smj.v76i9.268510

Keywords:

Cesarean delivery, Pain, Dexamethasone, Lidocaine

Abstract

Objective: This study aimed to compare the efficacy of additional local infiltration of dexamethasone and lidocaine among post-cesarean parturient underwent spinal anesthesia compared to the control group.

Materials and Methods: This randomized controlled trial was conducted at Thammasat University Hospital, Thailand, between June and November 2022. Singleton pregnant women who underwent cesarean delivery were randomized into 3 groups: dexamethasone (D), lidocaine (L), and control groups (C). Before skin closure, D, L and C group received infiltration of 16 mg of dexamethasone, 2% lidocaine with adrenaline and none, respectively. A visual analog scale (VAS, 0-10) was used for the evaluation of post-cesarean pain at two, four, six, eight, twelve, and twenty-four hours. VAS, demographic, and obstetric data were collected for analysis. Additional opioid was recorded for secondary outcome.

Results: A total of 279 participants were recruited and divided into 3 groups. Half of the participants (151/279) were nulliparity. Other demographics were similar. Subjects in the D group had lower moderate to severe pain after 6 hours onwards and less additional opioid requirement compared to the C and L groups significantly. Subjects in the L group had lower moderate to severe pain than the C group at 4 hours after surgery. Postoperative complications were comparable among the groups.

Conclusion: Local dexamethasone infiltration could reduce and prolong post-cesarean pain relief within 24 hours after cesarean delivery.

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