Effects of Epidural Dexamethasone Versus Intravenous Dexamethasone in Patients Undergoing Hysterectomy
Journal Title: PARIPEX-Indian Journal of Research - Year 2016, Vol 5, Issue 10
Abstract
BACKGROUND Role of steroids as a component of multi-model analgesia is well established. The limiting factor is hyperglycemia,decreased wound healing with high intravenous doses, especially in obese and those with impaired glucose tolerence. We tried to achieve the beneficial effects with smaller epidural dose. AIM To compare the hyperglycemic response to dexamethasone used intravenously with a smaller dose used epidurally. Antiemetic and opiod sparing effects are also studied. MATERIALS AND METHODS 50 patients in each group undergoing total abdominal hystrectomy were randomly allocated to group A receiving 8mg of dexamethasone intravenously and group B receiving 2mg of dexamethasone epidurally. Average postoperative analgesic requirement over 24 hours was found to be 160± 5ml in group A and 164 ±5ml in group B. Clinical investigation revealed that average increase in blood glucose concentrations 4 hours after gynecologic surgery from the baseline were 41 ± 7 mg/ dL in group A patients receiving iv dexamethasone and 6 ± 7 mg/dl in group B patients receiving epidural dexamethasone. RESULTS Intravenous dexamethasone was found to rise blood sugar significantly while lower epidural dose was found to be equipotent in terms of analgesic sparing effects and reducing PONV.
Authors and Affiliations
Dr. MADHU VELAYUDHAN, Dr. VENUGOPALAN P. G, Dr. KEERTHY. S
Keywords
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