Original Article Efficacy of Pre-operative Dexamethasone Administration for Post-operative Pain in Fracture Shaft Femur: A Prospective, Randomized, Double-blind, Placebo, and Controlled Study

Efficacy of Pre-operative Dexamethasone Administration for Post-operative Pain in Fracture Shaft Femur: A Prospective, Randomized, Double-blind, Placebo, and Controlled Study

Abstract

Introduction: One of the most common fractures met in orthopedics is femur fracture. Spinal anesthesia is the most used anesthetic technique. Multimodal pain control is modality which practiced the use of multiple analgesic medications, opioids, and non-opioids for pain control in the post-operative period. This modality is beneficial in all patients undergoing orthopedic surgeries and provides benefit from several different medications such as potentiation of effect, reduce adverse drug reactions and decrease the dose of opiates postoperatively. The aim of this study was to assess the efficacy of dexamethasone administration combined with single dose Pregabalin on severity of post operative pain and analgesic requirement. Methodology: In this prospective, randomized, double blind placebocontrolled trial 42 patients were enrolled. All the enrolled patients were randomly assigned to Group A and received Tab. Pregabalin 300 mg orally/1 h before spinal anesthesia + Inj. NS/IV (placebo) and Group B: Tab. Pregabalin 300 mg orally/1 h before spinal anesthesia + Inj. Dexamethasone 0.1 mg kg/IV. Placebo (NS) and dexamethasone injection was given after coming to the operation theater and just before induction of spinal anesthesia. Post-operatively, Inj. Acetaminophen was used as analgesic and Inj. Tramadol as rescue analgesic in addition on demand. Visual analogue score and dose of Tramadol consumption was compared. Results: Difference in the postoperative first 6hrs.Mean (SD) VAS score in group A and group B was statistically significant with P = 0.0004. It was 1.2 (0.7) in the dexamethasone group and 3.2 (2.1) in placebo group. Total dose of Tramadol administered in the first 24 h. of post operative period was less in dexamethasone group. Conclusion: Dexamethasone administration in preoperative period provides significant analgesic benefit in the early postoperative period and reduce postoperative analgesic requirement, following operative procedure in fracture shaft femur