Evaluation of Bupivacaine Local Infiltration Effect with or Without Dexamethasone On Severity of Acute Pain in Women Undergoing Cesarean Section

Introduction:The effectiveness of bupivacaine in reducing postsurgical pain has been a topic of debate in previous studies.Consequently, this study aimed to investigate the impact of dexamethasone and bupivacaine injection on pain intensity in patients undergoing cesarean surgery.Methods and Materials: In this double-blind randomized clinical trial, 75 pregnant women scheduled for cesarean section were divided into three groups, each consisting of 25 individuals.The first group received 0.5% bupivacaine in normal saline, the second group received 0.5% bupivacaine in normal saline along with dexamethasone, and the third group received an equivalent volume of normal saline as a control.Pain intensity was assessed using the Visual Analog Scale (VAS) at the time of entering recovery, one hour after surgery, and 24 hours after surgery.Findings: The administration of bupivacaine demonstrated superior pain control compared to the placebo, resulting in an average decrease of 2.88 points in the VAS pain score (P = 0.001, 95% CI = -1.81 to -3.95).Additionally, bupivacaine alone outperformed the combination of bupivacaine and dexamethasone, with an average reduction of 1.79 points in the VAS pain score (P = 0.001, 95% CI = -0.72 to -2.85).Conclusion: The findings of this study indicate that the use of bupivacaine can effectively reduce pain and the need for opioid painkillers in women undergoing cesarean section.However, the concurrent use of dexamethasone with bupivacaine diminishes its effectiveness to some extent.Our results indicate that the pains of three groups after injection of bupivacaine and bupivacaine/dexamethasone are in different levels.Also, the need for opioid painkillers in these three groups in order to reduce the pain are different.