Abstract :
Background: Glucocorticoids are well known for their analgesic, anti-inflammatory , immune-modulating and antiemetic
effects. The present study is done to see the effects of single dose IV administration of dexamethasone for postoperative
analgesia in elderly patients on selective population of Bundelkhand region hospitalized for lower limb orthopaedic
surgeries under spinal blockade. We found that duration of analgesia was dose dependent and patient receiving
dexamethasone had better pain tolerability. Methods: Study was carried out on 120 patients of either sex, more than 60
year of age. The patients were than randomly divided into four groups of 30 patients each. Group I(C): Patients were given
4 ml saline intravenously to serve as control group. Group II (D-8): Patients were given 8 mg dexamethasone diluted to 4ml
iv. Group III (D-12): Patients were given 12 mg dexamethasone diluted to 4ml iv. Group IV (D-16): Patients were given 16
mg dexamethasone diluted to 4ml iv. Pt. were observed for the following data: a. Onset of sensory block – tested by
appearance of paresthesia, b. Time to reach peak of sensory & motor blockade, c. Recovery of sensory & motor function,
d. Duration of anesthesia, e. Duration of complete analgesia- assessed by first demand for analgesic. Results: No
significant difference among the study groups, which were slightly earlier than the control group while comparing time of
onset of sensory/motor block. Duration of analgesia (time of onset of sensory block to first demand of analgesics): was
maximum (545.03±45.25 min.) in group IV followed by group III (305.36±25.35 min.), which was found to be highly
significant (p < 0.001) in comparison to group I (155.06±12.27 min) Group IV > Group III > Group II> Group I. Conclusion:
Onset of sensory and motor block was comparable in all the four groups. Duration of analgesia was dose dependent with
16 mg dose providing maximum duration of post-operative analgesia at rest in comparison to 12 mg and 8 mg dose.
Keyword :
Dexamethasone, Postoperative analgesia