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Objective: To evaluate efficacy of a single perioperative dose of dexamethasone on postoperative pain in gynecological laparotomy surgery.
Material and Method: A prospective, randomized, double-blinded study was approved by the Institutional Review Board and registered with the Thai Clinical Trials Registry as TCTR20151116001. Fifty-two patients scheduled for elective gynecological laparotomy surgery were enrolled in the present study. Patients were randomized into two groups based on computer generated random number list. After induction, group D received intravenous dexamethasone 8 mg and group P received saline. Both groups were anesthetized in a standardized manner. Postoperative pain was managed with intravenous morphine using patient controlled analgesia. The primary outcome was total morphine consumption evaluated at 6- and 24-hour postoperatively. Pain score, nausea, and vomiting, shivering, sore throat, and adverse effects of dexamethasone were also recorded.
Results: The total dose of morphine (0 to 24 hour after surgery) was less in D group (15.88±9.59 mg) compared with P group (24.25±15.26 mg) (p = 0.027). The doses during hour 0 to 6 were smaller in D group (11.28±6.66 mg) than the placebo (15.79±12.50) (p = 0.435). The numerical rating scale for pain at rest did not differ in both study groups, but pain in motion was less in D group than P group at 6-hour (p = 0.03) and 24-hour (p = 0.039) after surgery. No adverse effect was observed in both groups.
Conclusion: A single perioperative dose 8 mg of dexamethasone is safe and significantly reduces pain at movement and morphine consumption in 24 hours after gynecological laparotomy surgery.
Keywords: Dexamethasone, Postoperative pain, Gynecology laparotomy