Intravenous (IV) Dexamethasone in prolonging the duration of SUBARACHANOID BLOCK in pregnant patients undergoing Lower Segment Cesarean Section (LSCS)

Abstract

Objective: This double-blind randomized controlled trial evaluated the role of 8 mg of Intravenous IV Dexamethasone in prolonging the duration of analgesia offered by spinal anesthesia in patients undergoing Cesarean Section.

Methodology: This RCT was carried out department of Anesthesia, BBH, Rawalpindi from 20^th July,2025 to 20^thOctober,2025. The study enrolled 110 patients who fulfilled the inclusion criteria i.e.16 years to 40 years of age, American Society of Anesthesiologists (ASA) class: II presenting for elective Cesarean section under Spinal Anesthesia. After Sub-arachnoid block patients in group D received 8mg of IV Dexamethasone as a single dose while patients in group C received placebo. Time for block to regress by two dermatomes, time for first demand to rescue analgesia, incidence of intraoperative shivering, nausea and vomiting between two groups were noted and compared.

Results: Intravenous dexamethasone significantly prolonged the median time to rescue analgesia [6.95 vs. 3.56 hours, p<0.001] and delayed regression by two dermatomes [125 vs. 88 minutes, p<0.001] compared with placebo. Furthermore, the incidences of intraoperative nausea and vomiting (9.1% vs. 36.4%, p=0.001) and shivering (30.9% vs. 60.0%, p=0.002) were significantly reduced in the dexamethasone group.

Conclusion: Single dose of 8mg of IV Dexamethasone significantly prolongs the duration of Sub-Arachnoid block in terms of time for block to regress by two dermatomes, time to first rescue analgesia and decreased incidence of intraoperative shivering, nausea and vomiting in patients undergoing Cesarean section.

Keywords: Sub-Arachnoid Block, IV Dexamethasone, Rescue analgesia, Post spinal shivering, Intraoperative nausea and vomiting.