DEXAMETHASONE AS ADJUVANT TO CAUDAL ROPIVACAINE AS ANALGESIC FOR LABOR PAIN

Objectives: To evaluate analgesic yield of dexamethasone (DEX) as adjuvant to caudal ropivacaine (ROP)for labor pain. Patients Methods: 414 primigravida in their active phase of the first stage of labour divided randomly into two groups: ROP group received caudal ropivacaine and DEX group received caudal combination of ropivacaine and dexamethasone. Assessment included extent of sensory and motor blockade and requirement of anaesthesia for episiotomy repair and evaluation of post-episiotomy pain and postpartum complications. Results: Sensory blockade data showed a profound analgesic effect in both groups with superior effect in DEX group manifested as significantly earlier onset of analgesia in association with significantly prolonged duration of analgesia. Caudal block did not disturb process of delivery with nonsignificant difference between both groups. Twenty nine parturient had caesarean section and 385 had vaginal delivery. Episiotomy was repaired without perineal infiltration anaesthesia. Postpartum perineal pain scores were significantly lower in DEX group with significantly higher low pain scores and significantly request for analgesia for episiotomy related pain. Conclusion: Caudal ropivacaine/dexamethasone provided safe profound labor analgesia without interruption of progress of labor and spared the need for perineal anaesthesia for episiotomy repair and minimized the need for subsequent analgesia.