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ANALGESIA

The Effect of Intravenous Administration of Dexamethasone on Postoperative Pain, Nausea, and Vomiting After Intrathecal Injection of Meperidine

Ali Movafegh, MD^*, Ahmad Reza Soroush, MD, Ali Navi, Mustafa Sadeghi, MD^*, Fatimah Esfehani, MD, and Niloufar Akbarian-Tefaghi^||

From the *Department of Anesthesiology and Critical Care, Dr. Ali Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Surgery, Dr. Ali Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Tehran University of Medical Sciences, Tehran, Iran; Research Development Center, Dr Ali Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; and ||Liverpool John Moores University, Liverpool, United Kingdom.

Address correspondence and reprint requests to Ali Movafegh, MD, Department of Anesthesiology and Critical Care, Dr Ali Shariati Hospital, North Karegar Street, Tehran 1411713135, Iran. Address e-mail to movafegh{at}sina.tums.ac.ir

Abstract

BACKGROUND: Different drugs have been used to enhance postoperative neuraxial opioid analgesia and reduce adverse effects.

METHODS: We randomized 60 patients into 2 groups to receive either 2 mL saline or 0.1 mg/kg dexamethasone IV before the administration of intrathecal anesthesia (15 mg and meperidine 15 mg). After surgery, patients were asked to score their pain at 6, 12, 18, and 24 h. The presence of postoperative nausea and vomiting (PONV), pruritus and respiratory depression were recorded.

RESULTS: The total dose of diclofenac (P < 0.05), visual analog scale pain score at 6-h intervals (P < 0.001), and the incidence of PONV (P < 0.05) were significantly lower in the dexamethasone group.

CONCLUSIONS: Administration of IV dexamethasone prior to intrathecal meperidine injection enhances analgesia and reduces PONV.