The effect of dexamethasone as an adjuvant in spinal anesthesia for femur upper extremity surgery: a prospective randomized trial

Introduction: the aim of our study was to evaluate the efficacy of dexamethasone added to bupivacaine and sufentanilin spinal anesthesia to improve postoperative analgesiaafter femur upper extremity surgery. Methods: we conducted a prospective controlled, randomizeddouble-blinded clinical trial including patients proposed forsurgery of the upper extremity of the femur under spinal anesthesia. The patients were randomly allocated to receive intrathecally 10 mg hyperbaric bupivacaine 0.5% with 5 mu g sufentaniland 2 ml normal saline (control group) or 10 mg hyperbaric bupivacaine 0.5% with 5 mu gsufentaniland 8 mg dexamethasone (Dexa group). The patients were evaluated for onset time and duration of sensory block, duration of pain-free period, overage consumption of morphine in the 6 first postoperative hours,hemodynamic parameters, nausea, and vomiting, orother complications. Results: fifty-eigth patients were analyzed. There were no signification differences in demographic data and onset time of the sensory block between the two groups. Sensory block duration was 121.55 +/- 16.42 minutes in the control group and 183.62 +/- 33.93 minutes in the Dexa group which was significantly higher in the Dexa group (P<0.001). The pain-free period was longer in the Dexa group than in the control group (P<0.001). There was a reduction in morphine consumption during the first 6postoperative hours in the Dexa group against the control group (p=0.02). The frequency of complications was not different between the two groups. Conclusion: the addition of intrathecal dexamethasone in spinal anesthesia improved the postoperative analgesia after femur upper extremity surgery.