Effect of Single-Dose Dexamethasone on Postoperative Pain After Cesarean Section Under Spinal Anesthesia

Overview

This study looked at whether giving a single dose of dexamethasone (a steroid medicine, 8 mg given into the vein) before a cesarean section could reduce pain after the operation. Eighty women having a planned cesarean section under spinal anesthesia at KRL Hospital, Islamabad were divided into two equal groups by chance. One group received dexamethasone through a drip before the procedure; the other group received a harmless salt-water solution (normal saline) as a comparison. Pain levels were measured using a 0-10 pain scale at 2, 6, 12, and 24 hours after surgery. The study also recorded how long it took before patients needed an extra painkiller. The group that received dexamethasone reported significantly less pain at 6, 12, and 24 hours after surgery, and far fewer patients in that group needed additional pain relief (7.5% vs 65%). The drug was well tolerated with no major side effects. The findings suggest that a single pre-operative dose of dexamethasone is a simple and effective way to improve pain control after cesarean section.

Postoperative pain following lower segment cesarean section (LSCS) remains a significant clinical concern, particularly as spinal anesthesia wears off within the first few post-operative hours. Dexamethasone, a corticosteroid with known anti-inflammatory and analgesic properties, has been studied as an adjunct for postoperative pain control in various surgical settings. This randomized controlled trial enrolled 80 ASA I-II patients aged 18-40 years undergoing elective LSCS under spinal anesthesia. Patients were randomized into two groups (n=40 each) using non-probability consecutive sampling. Group A received intravenous dexamethasone 8 mg (2 ml) prior to induction; Group B received intravenous normal saline 0.9% (2 ml) as placebo. Standard spinal anesthesia was administered to all participants. Pain intensity was assessed using the Visual Analogue Scale (VAS, 0-10) at 2, 6, 12, and 24 hours postoperatively. Rescue analgesia was administered when VAS exceeded 4. Time to first rescue analgesia was recorded as a secondary outcome.