Dexamethasone added to bupivacaine prolongs duration of epidural analgesia

Abstract

Background: Different additives have been used to prolong regional blockade. We designed a prospective, randomized, double-blind, controlled clinical trial to evaluate the effect of dexamethasone added to bupivacaine-fentanyl on the duration of postoperative analgesia via epidural catheterization.

Methods: Seventy two adult patients scheduled for elective abdominal or thoracic surgery under epidural anesthesia were randomly allocated into two groups to receive either bupivacaine (0.5%) - fentanyl (50 microg) and dexamethasone (8 mg) in lumbar or thoracic epidural anesthesia (Dexa group, n=36), or bupivacaine-fentanyl and saline normal (control group, n=36) via epidural catheter. Duration of analgesia, postoperative pain score and IV analgesic use at first 24 hours were recorded and compared.

Results: Two patients were excluded (one in each group) due to unsuccessful blockade. Age, gender and duration of surgery were similar in the two groups (p>0.05). The duration of analgesia (372< or = 58.1 vs. 234.6+/- 24.3 min) was significantly longer and pain score and pentazocine use were less in the Dexa than the control group (37.1+/- 19.7 mg v.s. 73.1 +/- 17.6 mg, respectively; p=0.001).

Conclusions: This study revealed that dexamethasone added to bupivacaine-fentanyl solution in epidural analgesia prolongs the duration of analgesia in abdominal or thoracic surgery.