الفهرس | Only 14 pages are availabe for public view |
Abstract This study concluded that the use of intrathecal dexamethasone in low dose (2mg) increase the duration of spinal anesthesia and decrease the post operative VAS score and analgesia with less complications compared to intravenous dexamethasone. Hence, intrathecal dexamethasone administration can be recommended in this regard. SUMMARY One of the main objectives of anesthesia is to alleviate the patient’s pain and agony, by ensuring the performance of surgical procedures without any discomfort. Elimination of postoperative pain is indispensable due to the central, peripheral and immunological stress response to tissue injury. So there is a need for extended analgesia without any side effects to achieve this goal. The use of opioids in intrathecal or epidural anesthesia has become common to increase postoperative analgesia. However, opioid-induced side effects, such as respiratory depression, nausea, vomiting, urinary retention and pruritus, limit their use. The purpose of this study was to evaluate the effect of intravenous versus intrathecal dexamethasone with subarachnoid anesthesia in patients undergoing elective cesarean section, surgery. The duration of analgesia and effect on hemodynamic parameters were evaluated. Moreover, undesirable side effects. Groups: 66 participants were randomly allocated in three groups: o Control group (n= 22): Participants were received normal saline 2 mL intravenously with intrathecal injection of heavy bupivacaine 0.5% 2 mL (10mg) plus 1 mL of 0.9% saline, overall 3 ml volume intrathecally (Pyasetska, 2020). o IT group (n= 22): Participants were received normal saline 2 mL intravenously with intrathecal injection of heavy bupivacaine 0.5% 2 mL (10mg) plus 0.5 mL (2mg) dexamethasone diluted in 0.5 ml of 0.9% saline, overall 3 ml volume intrathecally. The dose of 2mg of dexamethasone was demonstrated by Amer Shammout and Basci (2018) to be the least effective intrathecal dose. o IV group (n= 22): Participants were received dexamethasone 2 mL (8mg) intravenously with intrathecal injection of heavy bupivacaine 0.5% 2 mL plus 1 mL of 0.9% saline (Pyasetska, 2020). After completing the intrathecal injection, the patient was immediately placed in the supine position. IV Ringer’s solution 10 ml/kg/hour was administered throughout the surgery. Oxygen was administered through a nasal cannula in a rate of 2 L/min. Results of this study: This study showed that low dose intrathecal Dexamethasone dose(2mg) still have more potent effect than Intravenous Dexamethasone (8mg) in prolonging the spinal anesthesia duration without any significant adverse effects in patients undergoing lower segment cesarean section under spinal anesthesia. |