title: Dexamethasone added to bupivacaine prolongs duration of epidural analgesia.
abstract: BACKGROUND
  Different additives have been used to prolong regional blockade. We designed a prospective, randomized, double-blind, controlled clinical trial to evaluate the effect of dexamethasone added to bupivacaine-fentanyl on the duration of postoperative analgesia via epidural catheterization.
  
  
  METHODS
  Seventy two adult patients scheduled for elective abdominal or thoracic surgery under epidural anesthesia were randomly allocated into two groups to receive either bupivacaine (0.5%) - fentanyl (50 microg) and dexamethasone (8 mg) in lumbar or thoracic epidural anesthesia (Dexa group, n=36), or bupivacaine-fentanyl and saline normal (control group, n=36) via epidural catheter. Duration of analgesia, postoperative pain score and IV analgesic use at first 24 hours were recorded and compared.
  
  
  RESULTS
  Two patients were excluded (one in each group) due to unsuccessful blockade. Age, gender and duration of surgery were similar in the two groups (p>0.05). The duration of analgesia (372< or = 58.1 vs. 234.6+/- 24.3 min) was significantly longer and pain score and pentazocine use were less in the Dexa than the control group (37.1+/- 19.7 mg v.s. 73.1 +/- 17.6 mg, respectively; p=0.001).
  
  
  CONCLUSIONS
  This study revealed that dexamethasone added to bupivacaine-fentanyl solution in epidural analgesia prolongs the duration of analgesia in abdominal or thoracic surgery.
authors.affiliation: Department of Anesthesiology, Madani Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Bahman
authors.initials: B
authors.lastname: Naghipour
authors.forename: Dawood
authors.initials: D
authors.lastname: Aghamohamadi
authors.forename: Rasoul
authors.initials: R
authors.lastname: Azarfarin
authors.forename: Moussa
authors.initials: M
authors.lastname: Mirinazhad
authors.forename: Eissa
authors.initials: E
authors.lastname: Bilehjani
authors.forename: Dorosti
authors.initials: D
authors.lastname: Abbasali
authors.forename: Samad E J
authors.initials: SE
authors.lastname: Golzari
mesh_terms: D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D000779:Anesthetics, Local; D003907:Dexamethasone; D002045:Bupivacaine