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Effect of Dexamethasone versus Fentanyl on shoulder tip pain during laparoscopic ovarian cystectomy under spinal anaesthesia. Accepted for publication in Revista Chilena de Anestesia

مؤلف البحث
Saeid Elsawy and Rasha Hamed
مجلة البحث
Revista Chilena de Anestesia
ملخص البحث

Background: General anesthesia is the typical anesthetic technique for laparoscopic intervention, however, the use of regional anesthesia in the laparoscopic field started to gain familiarity. Shoulder tip pain is a major intraoperative concern that may hinder the feasibility of laparoscopic interventions under spinal anesthesia.

Aim of the study: To evaluate the effect of the intrathecal addition of dexamethasone versus fentanyl on the severity of intraoperative shoulder tip pain during gynecologic laparoscopic surgeries.

 Methods: This RCT included 120 patients, randomized into three equal groups (Group D: received 15 mg bupivacaine and 8 mg dexamethasone intrathecally, Group F: received 15 mg bupivacaine and 25 µg fentanyle intrathecally and Group C: received 15 mg bupivacaine and normal saline intrathecally.

 Results: Significantly fewer patients experienced intraoperative shoulder tip pain in Groups F (n=17) and D (n=19) compared with Group C (n=30), P < 0.005, with no statistical difference detected between Groups D and C. Only two patients in both Groups D and F experienced moderate pain intensity versus eight patients in Group C, P = 0.011. The incidence of postspinal shivering was lower in Groups D and F in comparison to Group C; P = 0.002.

Conclusion:

The use of dexamethasone or fentanyle intrathecally may reduce the incidence and severity of shoulder tip pain during laparoscopic ovarian cystectomy under spinal anesthesia.

Keywords: Dexamethasone, Laparoscopy, Fentanyl, Shoulder Tip Pain, Spinal Anesthesia.