Dexamethasone and Lidocaine Effects in 24 hours Post Cesarean Pain Reduction under Spinal Anesthesia: A Randomized Controlled Trial

Objective: This study aimed to compare the efficacy of additional local infiltration of dexamethasone and lidocaine among post-cesarean parturient underwent spinal anesthesia compared to the control group. Materials and Methods: This randomized controlled trial was conducted at Thammasat University Hospital, Thailand, between June and November 2022. Singleton pregnant women who underwent cesarean delivery were randomized into 3 groups: dexamethasone (D), lidocaine (L), and control groups (C). Before skin closure, D, L and C group received infiltration of 16 mg of dexamethasone, 2% lidocaine with adrenaline and none, respectively. A visual analog scale (VAS, 0-10) was used for the evaluation of post-cesarean pain at two, four, six, eight, twelve, and twenty-four hours. VAS, demographic, and obstetric data were collected for analysis. Additional opioid was recorded for secondary outcome. Results: A total of 279 participants were recruited and divided into 3 groups. Half of the participants (151/279) were nulliparity. Other demographics were similar. Subjects in the D group had lower moderate to severe pain after 6 hours onwards and less additional opioid requirement compared to the C and L groups significantly. Subjects in the L group had lower moderate to severe pain than the C group at 4 hours after surgery. Postoperative complications were comparable among the groups. Conclusion: Local dexamethasone infiltration could reduce and prolong post-cesarean pain relief within 24 hours after cesarean delivery.