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. 2011 Oct;5(4):382-6.
doi: 10.4103/1658-354X.87267.

Addition of intrathecal Dexamethasone to Bupivacaine for spinal anesthesia in orthopedic surgery

Nadia Bani-Hashem  1 , Bahman Hassan-Nasab, Ebrahim Alijan Pour, Parviz Amri Maleh, Aliakbar Nabavi, Ali Jabbari
Affiliations

Addition of intrathecal Dexamethasone to Bupivacaine for spinal anesthesia in orthopedic surgery

Nadia Bani-Hashem et al. Saudi J Anaesth. 2011 Oct.

Abstract

Objectives: Spinal anesthesia has the advantage that profound nerve block can be produced in a large part of the body by the relatively simple injection of a small amount of local anesthetic. Intrathecal local anesthetics have limited duration. Different additives have been used to prolong spinal anesthesia. The effect of corticosteroids in prolonging the analgesic effects of local anesthetics in peripheral nerves is well documented. The purpose of this investigation was to determine whether the addition of dexamethasone to intrathecal bupivacaine would prolong the duration of sensory analgesia or not.

Methods: We conducted a randomized, prospective, double-blind, case-control, clinical trial. A total of 50 patients were scheduled for orthopedic surgery under spinal anesthesia. The patients were randomly allocated to receive 15 mg hyperbaric bupivacaine 0.5% with 2 cc normal saline (control group) or 15 mg hyperbaric bupivacaine 0.5% plus 8 mg dexamethasone (case group) intrathecally. The patients were evaluated for quality, quantity, and duration of block; blood pressure, heart rate, nausea, and vomiting or other complications.

Results: There were no signification differences in demographic data, sensory level, and onset time of the sensory block between two groups. Sensory block duration in the case group was 119±10.69 minutes and in the control group was 89.44±8.37 minutes which was significantly higher in the case group (P<0.001). The duration of analgesia was 401.92±72.44 minutes in the case group; whereas it was 202±43.67 minutes in the control group (P<0.001). The frequency of complications was not different between two groups.

Conclusion: This study has shown that the addition of intrathecal dexamethasone to bupivacaine significantly improved the duration of sensory block in spinal anesthesia without any changes in onset time and complications.

Keywords: Bupivacaine; dexamethasone; intrathecal; sensory block; spinal anesthesia.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Sensory block level in the bupivacaine-dexamethasone versus bupivacaine-normal saline group
See this image and copyright information in PMC

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References

    1. Brown D. Spinal, Epidural and caudal anesthesia. In: Miller RD, editor. Miller's Anesthesia. 7th ed. Philadelphia: Churchill living stone; 2010. pp. 1611–38.
    1. Murali KT, Panda NB, Batra YK, Rajeev S. Combination of low doses of intrathecal Ketamine and midazolam with bupivacaine improves postoperative analgesia in orthopedic surgery. Eur J Anesthesiol. 2008;25:299–306. - PubMed
    1. Chakraborty S, Chakrabarti J, Bhattacharya D. Intrathecal tramadol added to bupivacaine as spinal anesthetic increases analgesic effect of the spinal blockade after major gynecological surgeries. Indian J pharmacol. 2008;40:180–2. - PMC - PubMed
    1. Yu SC, Ngan Kee WD, Kwan AS. Addition of meperidine to bupivacaine for spinal anesthesia for cesarean section. Br j Anesth. 2002;88:379–83. - PubMed
    1. Alhashemi JA, Kaki AM. Effect of intrathecal tramadol administration post operative pain after transurethral resection of prostate. Br J Anesth. 2003;91:536–40. - PubMed