Effects of 4 mg and 8 mg Dexamethasone Added to Intrathecal Bupivacaine on Perioperative Analgesia Among Adult Orthopedic Patients at Sodo Christian Hospital: A Prospective Cohort Study.

Abstract

Background: Several adjuvant drugs have been tried to prolong spinal anesthesia block. Currently, dexamethasone appears to be effective in extending the duration of sensory block and enhancing analgesia during surgery. It is unclear, however, whether administering dexamethasone at a dose of 8 mg offers any advantages over administering it at a dose of 4 mg. Objective: To compare the effect of adding 4 and 8 mg dexamethasone to intrathecal bupivacaine on perioperative analgesia among adult orthopedic patients at Sodo Christian Hospital from June 1 to October 31, 2021. Methodology: A total of 178 adult patients undergoing elective orthopedic surgery were randomly assigned to one of the two groups through a prospective cohort research design. A systematic random sampling method was used. For analysis, data were imported into EpiData v.4.6 and exported to SPSS v.25. Levene's test was used to verify homogeneity of variance, whereas the Shapiro-Wilk test was used to assess data distribution. The Mann-Whitney test and the independent sample t-test were employed to compare numerical variables between study groups. Category variables were determined using the chi-square test. p values were deemed statistically significant if they were less than 0.05. Result: Between groups, the perioperative and demographic features were similar. The mean durations of sensory block (347.42 ± 91.06 versus 341.46 ± 68.84), motor block (308.36 ± 80.91 versus 310.84 ± 75.50), and overall analgesia (421.51 ± 121.62 versus 412.40 ± 107.0) minutes did not show a statistically significant difference between the groups. In addition, there was no significant difference (p > 0.05) in postoperative analgesic use, initial analgesia rescue time, or pain severity, as measured by the Numerical Rating Scale (NRS). The addition of dexamethasone did not result in any issues, nor was there a statistically significant difference in the onset time between the two groups. Conclusion: Dexamethasone at a dose of 4 mg extends the duration of sensory, motor, and overall analgesia in a manner similar to that of 8 mg dexamethasone with comparable durations for both the initial analgesic request and overall analgesic use.