Anesthesia
Olumide Mathew Adebisi; Adebayo Augustine Adeniyi; Olabisi Timothy Adeyemo; Olayinka Tesleem Orewole; Olumide Emmanuel Adewara; Babatunde Sunday Awoyinka; Idowu Oluwaseyi Adebara; Adewumi Bakare; Oluwasesan Bamidele Afolabi; Adeola Emmanuel Adekanye
Articles in Press, Accepted Manuscript, Available Online from 01 December 2023
Abstract
Background and Objective: The commonly used analgesia for post caesarean pain include combination regimens containing acetaminophen, non-steroidal anti-inflammatory agents (NSAIDs) and opioids. The objective of this study is inter alia to determine the effects of dexamethasone as adjuvant to commonly ...
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Background and Objective: The commonly used analgesia for post caesarean pain include combination regimens containing acetaminophen, non-steroidal anti-inflammatory agents (NSAIDs) and opioids. The objective of this study is inter alia to determine the effects of dexamethasone as adjuvant to commonly used NSAIDs for post-caesarean pain management.
Materials and methods: One hundred and eighty-eight participants slated for caesarean delivery under spinal anaesthesia were randomized into two groups of 94 participants each. One group received 2ml intravenous 8mg dexamethasone while the second group received 2ml of intravenous sterile water as placebo . Both groups received similar doses of intramuscular acetaminophen and diclofenac. Intramuscular pentazocine at a dose of 0.5mg/kg body weight was used as rescue analgesia. Primary outcome was the mean summed pain intensity difference (MDPID) in the two groups while the secondary outcomes include the needs and frequency of rescue analgesia, and the levels of maternal satisfaction. P-value set as ≤0.05.
Results: The mean summed pain intensity difference (MSPID) at 24hours post-caesarean was higher in the dexamethasone group, (29.27±18.10 versus 24.24±13.14, p=0.036). The percentage of the participants that required rescue analgesia in the dexamethasone group was less (60.6% versus 76.1%, p=0.024). The Overall levels of maternal satisfaction were comparable in both groups.
Conclusion: Intraoperative dexamethasone given intravenously as adjuvant to intramuscular diclofenac and acetaminophen minimizes opioid administration within the first 24hours after caesarean section.
Obstetrics and Gynecology
Mahboobeh Shirazi; Mehnoosh Torkzaban; Samira Fallah; Marjan Ghaemi
Volume 7, Issue 1 , September and October 2021, , Pages 20-24
Abstract
Background and Objective: Pain is the most common side effect of induced medical abortion. However, the optimal analgesia method remains as a clinical challenge. This study aimed to compare the efficacy of two methods of administration of diclofenac as a prophylactic or a therapeutic in pain management ...
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Background and Objective: Pain is the most common side effect of induced medical abortion. However, the optimal analgesia method remains as a clinical challenge. This study aimed to compare the efficacy of two methods of administration of diclofenac as a prophylactic or a therapeutic in pain management in induced second-trimester medical abortion. Materials and Methods: This randomized clinical trial study was conducted upon pregnant women who were candidates for induced medical abortion and referred to a tertiary educational hospital between October 2019 and December 2020. Participants were divided into two groups based on the mode of diclofenac administration, which was either simultaneously with the first dose of misoprostol or after beginning of the pain. Pain severity, induction-to-abortion time interval, total misoprostol dosage, Hemoglobin concentration, length of hospitalization, and size of retained pregnancy products by ultrasound, and the cumulative dose of opioid usage were compared between the groups.Results: The severity of pain which was measured by a visual analog scale (VAS), residual of conceived products, hospitalization days, and the total misoprostol dosage were significantly lower (P < /em><0.05) in the prophylaxis compared to the treatment group.Conclusion: Simultaneous administration of diclofenac with misoprostol as prophylactic method of pain management may be an optimal method in induced medical abortion in the second trimester.