Epidural versus intravenous dexamethasone as adjuncts to epidural analgesia in lumbar spine surgery : A randomized control trial / Ahmed Abdelmottaleb Rashad Abdelmottaleb ; Supervised Hesham Abdelwahab Abueldahab , Rania Samir Fahmy , Mohamed Farid Elemady

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Anesthesia

Background: It has been well documented that immediate postoperative pain control can significantly affect the outcome of surgical procedures and operative morbidity. Pain control plays an important role in early ambulation and accelerates functional recuperation. SUBJECTS & METHODS: ninety (90) cases of both sexes aged between 20 and 50 years, undergoing single level lumbar spine surgery were included in a randomized control trail to receive epidural analgesia in lumbar spine surgery, patients were randomly allocated into three groups, 30 patients each; group A received 8 mg IV dexamethasone along with epidural 0.5% bupivacaine, group B received 8 mg epidural dexamethasone along with epidural 0.5% bupivacaine, group C only received epidural 0.5% bupivacaine followed by infusion of 0.125% epidural bupivacaine in the three groups till the end of surgery. Time to first analgesic rescue as well as the number of analgesic doses required in 1st 24 hours, postoperative VAS score, onset of sensory and motor blocks, intra and postoperative haemodynamics, blood sugar measurements and side effects as nausea and vomiting were recorded. Results: The time to first analgesic rescue was prolonged in both groups A and B in comparison to group C (P value 0.011 and 0.001 respectively), group A and B as well showed a statistically significant lower number of doses of analgesic in comparison to group C (P value 0.02 and < 0.001 respectively). On the other hand, there was no statistically significant difference in onset of sensory and motor blocks, hemodynamic parameters, blood sugar measurements and side effects between the three study groups

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