ONSET AND DURATION OF ACTION OF EPIDURAL BUPIVACAINE AND DEXAMETHASONE IN PATIENTS UNDERGOING BILATERAL INGUINAL HERNIORRHAPHY

Afolayan Jide Michael*, Olajumoke T. O. and Olaogun Julius

ABSTRACT

Objective: To evaluate the onset and action of epidural bupivacaine with or without dexamethasone in patients
undergoing bilateral herniorraphy. Methods: A prospective study of epidural bupivacaine with or without
dexamethasone in patients with bilateral inguinal herniorraphy from January 2015 to December 2020 was carried
out. A total of forty-eight patients were enrolled in this double-blind study. Forty-eight patients were randomized
into group BD (N=24) and received 20ml of epidural bupivacaine plus 3ml (12mg) of dexamethasone or group BN
(N=24) and received 20 ml of epidural bupivacaine plus 3ml of normal saline. The onset of sensory block, mean
arterial blood pressure, duration of action and incidence of complications were recorded. Results: Effective
intraoperative sensory block was achieved in all the patients in the two groups. The onset of epidural anesthesia
was significantly more rapid in the epidural group with dexamethasone than in the epidural group without
dexamethasone (P < 0.001). Duration of analgesia was markedly prolonged in the group with dexamethasone
compared to control group (P < 0.001). One patient (4.2%) in the control group had bradycardia in the immediate
post operative period (P = 0.030). Two patients in the dexamethasone group had bradycardia. None of the patients
had vomiting in the two groups. Conclusions: This study showed that addition of 12mg dexamethasone to epidural
bupivacaine is safe, significantly makes onset of action to be more rapid and prolongs the duration of postoperative
analgesia.

Keywords: Anaesthesia, analgesia, epidural, bupivacaine, dexamethasone.