மயக்க மருந்து & மருத்துவ ஆராய்ச்சி
திறந்த அணுகல்
ஐ.எஸ்.எஸ்.என்: 2155-6148
ஐ.எஸ்.எஸ்.என்: 2155-6148
Becky Jno-Baptiste, Marinna D Scarlett and Hyacinth E Harding
Background: The necessity to improve post-operative analgesia and hence patients’ satisfaction has been the driving force of the quest for easy-to-administer, cost effective and safe analgesic agents. Dexamethasone is a powerful anti-inflammatory, analgesic and anti-emetic agent, that has been found to decrease opioid use, yet improve post-operative analgesia in a wide range of surgical patients.
Objectives: To determine if a single dose of intravenous Dexamethasone (0.5 mg/kg, not exceeding 40 mg), administered preoperatively, decreased post-operative opioid requirements without adverse effects in a cohort of Jamaican patients. Study design: A randomized, single-centre, single-blinded study was conducted over a six (6) month period. Patients, 18-60 years, scheduled to undergo gynecological surgery under general anesthesia, were recruited for the study, and were enrolled in either Group A, the control or B, the study group. Anesthesia was standardized and included intravenous Morphine (0.1 mg/kg) and Diclofenac sodium 75 mg, for preemptive analgesia. Pain intensity, sedation level, post-operative opioid/narcotic usage and satisfaction with pain management were assessed at 3, 6, 9 and 12 hours post-operatively.
Results: Total Pethidine consumption for the control group (A) was significantly higher (5200 mg) than the study Group (B), 3800 mg (p=0.008). Age of patients and length of surgery were not found to influence Pethidine requirements (p=0.338 and 0.131 respectively). Pain intensity was significantly lower in Group B at the 12-hour assessment, p=0.019, and earlier discharge home was also noted. No adverse effects of Dexamethasone were observed.
Conclusion: A single intravenous dose of Dexamethasone had a positive effect on post-operative pain management and patient satisfaction in a cohort of Jamaican patients.