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. 2024 Dec 17;16(12):e75877.
doi: 10.7759/cureus.75877. eCollection 2024 Dec.

Comparison of Lignocaine-Dexamethasone vs. Lignocaine-Triamcinolone for Preventing Post Spinal-Epidural Backache: A Randomized Study

Ankit Soni  1 , Brijesh P Singh  1 , Vinod K Srivastava  1 , Ravi Prakash  1 , Shefali Gautam  1 , Gyan Prakash Singh  1
Affiliations

Comparison of Lignocaine-Dexamethasone vs. Lignocaine-Triamcinolone for Preventing Post Spinal-Epidural Backache: A Randomized Study

Ankit Soni et al. Cureus. .

Abstract

Background: The primary objective of this study was to compare the efficacy of lignocaine-dexamethasone and lignocaine-triamcinolone infiltration, along the spinal-epidural needle insertion pathway, to prevent backache after lower abdominal surgeries.

Methods: This prospective, double-blind randomized controlled study included a total of 150 patients, scheduled for elective lower abdominal surgery under combined spinal-epidural (CSE) anaesthesia. The patients were randomised into three groups Group L (Lignocaine, n=50), Group DL (Dexamethasone, Lignocaine, n=50), and Group TL (Triamcinolone, Lignocaine, n=50).

Results: The Visual Analogue Score (VAS) was used to assess the postoperative pain. The anthropometric and demographic findings were comparable among the three groups. The mean VAS score at the time points of needle placement and at postoperative time periods of 24 hours, 48 hours, 72 hours, one month, two months and three months were significantly lower (p<0.001) in groups DL and TL compared to group L.

Conclusion: This study demonstrated that the addition of a steroid like triamcinolone or dexamethasone with lignocaine for local infiltration along the spinal-epidural tract significantly lowers the severity of post-needle puncture backache in comparison to lignocaine alone in lower abdominal surgeries.

Keywords: backache; combined spinal epidural anaesthesia; dexamethasone; lower abdominal surgeries; triamcinolone.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional ethical committee, King George's Medical University, Lucknow issued approval 1774/ethics/2022. The study has been approved by the institutional ethical committee (with the registration number ECR/26/Inst/UP/2013/RR-19), King George's Medical University, Lucknow, India. The trial was registered in Clinical Trials Registry - India (CTRI) with registration no. CTRI/2023/08/057040 on August 27, 2023. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

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