Comparative study between the effect of postoperative analgesia using intravenous dexamethasone versus intravenous pethidine in patients undergoing surgical repair of fractured neck femur

Background: Pain is the most dreaded fear associated with bone fractures.Intravenous opioids have been commonly used to manage the pain but their side effects like respiratory depression, cognitive impairment, vomiting, urinary retention.Dexamethasone is a synthetic adrenocortical steroid used widely as an antiemetic in surgical patients.Dexamethasone can induce long-acting postoperative analgesia for 24 hours and more.Objective: Comparative study between patients who received preoperative intravenous dexamethasone and those who received preoperative intravenous pethidine in postoperative analgesia using a visual analog scale.Patients and methods: This prospective randomized study was performed in Aswan University Hospital on 60 adult patients aged from 20 up to 70-yearsold of both genders, with ASA physical status I and II.Results: We found that there was a significant difference between the studied groups in VAS that was higher in the opioid group when compared with the dexamethasone group at 4hrs, 6hr, 8hrs, 12hrs, and 24hrs postoperative.Regarding rescue analgesia; we found that no significant difference between the two study groups regarding the request of additional analgesia, the first request, or the total pethidine consumption.As regards complications, there was no significant difference between the two study groups regarding postoperative nausea and vomiting, and no other complications were found.Conclusion: Intravenous dexamethasone is a promising analgesia for postoperative pain following femoral neck fracture with minimal side effects and no complications.