Intravenous Dexamethasone Reduces Pain in Middle Ear Surgery

Abstract

Introduction: Few studies evaluated the treatment of postoperative pain in middle ear surgery.

Materials and methods: We conducted a randomized clinical trial to evaluate the efficacy of dexamethasone in the management of postoperative pain in middle ear surgery. Group G1 received an intravenous injection of 2 ml of physiological saline 30 minutes before the end of the procedure. Group G2 received a 2 ml intravenous solution containing 8 mg of dexamethasone, 30 minutes before the end of the procedure. Pain perception was measured by the Visual analog scale (VAS) every 10 min during the first hour and then every 6 hours during the 24 hours postoperatively. The delay of the first analgesic demand and the consumption of analgesics use during the first 24 hours postoperatively, were recorded.

Results: VAS values were lower in G2at all measurement points during the first hour, as well as the first 24h postoperatively (Mann-Whitney test, P<0.05).The delay of the analgesic request was (0 (0-60) for G1 versus 0 (0-80) for G2, P=0.04, Mann-Whitney test). Morphine was used in 44% of the patients in G1 against 19% for G2 (P = 0.031). There was a significant difference between G1 and G2 in terms of the total dose of morphine consumed (P= 0.028, Mann-Whitney test). Paracetamol demand was lower in group 2 at all points of assessment during the first 24 hours postoperatively.

Conclusions: Intravenous dexamethasone is effective in decreasing pain and analgesic requirement, during the first 24 hours postoperatively, in patients undergoing middle ear surgery.

Keywords: Analgesia; Dexamethasone; Middle ear; Postoperative pain.