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. 2016 Jul-Sep;10(3):322-7.
doi: 10.4103/1658-354X.179096.

Efficacy of epidural local anesthetic and dexamethasone in providing postoperative analgesia: A meta-analysis

B Jebaraj  1 , P Khanna  1 , D K Baidya  1 , S Maitra  1
Affiliations

Efficacy of epidural local anesthetic and dexamethasone in providing postoperative analgesia: A meta-analysis

B Jebaraj et al. Saudi J Anaesth. 2016 Jul-Sep.

Abstract

Background: Dexamethasone is a potent anti-inflammatory, analgesic, and antiemetic drug. Individual randomized controlled trials found a possible benefit of epidural dexamethasone. The purpose of this meta-analysis is to estimate the benefit of epidural dexamethasone on postoperative pain and opioid consumption and to formulate a recommendation for evidence-based practice.

Materials and methods: Prospective, randomized controlled trials comparing the analgesic efficacy of epidural local anesthetic and dexamethasone combination, with local anesthetic alone for postoperative pain management after abdominal surgery, were planned to be included in this meta-analysis. PubMed, PubMed Central, Scopus, and Central Register of Clinical Trials of the Cochrane Collaboration (CENTRAL) databases were searched for eligible controlled trials using the following search words: "Epidural", "dexamethasone", and "postoperative pain", until February 20, 2015.

Results: Data from five randomized control trials have been included in this meta-analysis. Epidural dexamethasone significantly decreased postoperative morphine consumption (mean difference -7.89 mg; 95% confidence interval [CI]: -11.66 to -3.71) and number of patients required postoperative rescue analgesic boluses (risk ratio: 0.51; 95% CI: 0.41-0.63).

Conclusion: The present data shows that the addition of dexamethasone to local anesthetic in epidural is beneficial for postoperative pain management.

Keywords: Dexamethasone; epidural; opioid consumption; postoperative pain.

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Figures

Figure 1
Figure 1
PRISMA flow diagram of study selection
Figure 2
Figure 2
Forest plot for mean difference of postoperative morphine consumption
Figure 3
Figure 3
Forest plot for risk ration of number of patients required postoperative rescue analgesic
See this image and copyright information in PMC

References

    1. Coutinho AE, Chapman KE. The anti-inflammatory and immunosuppressive effects of glucocorticoids, recent developments and mechanistic insights. Mol Cell Endocrinol. 2011;335:2–13. - PMC - PubMed
    1. Gan TJ, Diemunsch P, Habib AS, Kovac A, Kranke P, Meyer TA, et al. Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2014;118:85–113. - PubMed
    1. De Oliveira GS, Jr, Castro-Alves LJ, Ahmad S, Kendall MC, McCarthy RJ. Dexamethasone to prevent postoperative nausea and vomiting: An updated meta-analysis of randomized controlled trials. Anesth Analg. 2013;116:58–74. - PubMed
    1. Chatterjee S, Rudra A, Sengupta S. Current concepts in the management of postoperative nausea and vomiting. Anesthesiol Res Pract. 2011;2011:748031. - PMC - PubMed
    1. Dietrich J, Rao K, Pastorino S, Kesari S. Corticosteroids in brain cancer patients: Benefits and pitfalls. Expert Rev Clin Pharmacol. 2011;4:233–42. - PMC - PubMed