Perioperative Dexamethasone versus Placebo as an Adjunct Analgesic for Caesarean Section in a Nigerian Tertiary Hospital: A Double-Blind Randomized Controlled Trial

Context: Pain is the major complaint following Caesarean section. Opioids are used for postoperative analgesia, though unwanted side effects limit its use. Aim: To determine the effect of perioperative dexamethasone as an adjunct analgesic for pain relief after Caesarean section. Settings and Design: Double-blind randomized controlled trial conducted on 146 women who had caesarean section in a Tertiary hospital in Nigeria. Methods and Materials: Seventy-three participants each had perioperative 8mg (2ml) dexamethasone or 2ml normal saline as placebo intravenously. Participants were 1 gram of intravenous paracetamol as a form of analgesia after Caesarean section. Participants were reviewed periodically and when there were moderate pain (Verbal Rating Score≥2) or participants requested for analgesia, they would be excited and commenced on pentazocine and diclofenac. Statistical analysis used: Data were analyzed using SPSS version 23 with categorical and continuous variables compared using Chi-square test and Student t-test respectively. Level of significance was set as < 0.05. Results: At 2 hours after Caesarean section, 12.3% of those who were given Dexamethasone had moderate pain while 72.6% of those administered Placebo groups had moderate pain. At 4 hours postoperative, 87.7% of those given Dexamethasone remained in the study because they were yet to have