ASSESS THE EFFICACY OF INTRAVENOUS DEXAMETHASONE IN DECREASING INCIDENCE OF SPINAL ANESTHESIA INDUCED HYPOTENSION, NAUSEA AND VOMITING IN PARTURIENT UNDERGOING CESAREAN SURGERY IN LARGE TWO HOSPITAL IN PALESTINE: COHORT OBSERVATIONAL STUDY
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Date
2024-10-02
Authors
Abdallah, Ayala
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An-Najah National University
Abstract
Spinal anesthesia is the method most commonly used for caesarean sections because of its rapid onset and provides better analgesia, but it may lead to hypotension, nausea, and vomiting, as well as compromise maternal and fetal outcomes. The aim of this observational study was to evaluate the effectiveness of intravenous dexamethasone in preventing hypotension, nausea, and vomiting, secondary to spinal anesthesia among women undergoing cesarean section at Rafidia Palestine Hospital. Standardized procedures for administering dexamethasone to patients undergoing spinal anesthesia during cesarean section should be established and implemented. And to be included in treatment plans A total of 100 parturient were included in the study, with one group receiving a standard dose of intravenous dexamethasone prior to spinal anesthesia and the control group receiving a placebo. The primary endpoints studied were the incidence of spinal anesthesia-induced hypotension, intraoperative nausea, and vomiting associated with its use as well as after surgery The results were analyzed using SPSS v22, and to describe the sample, descriptive analysis (mean and standard deviation) was used. A parametric statistical test called Repeated measures ANOVA was applied. For multivariate analyzes of variance (MANOVA), a parametric test statistic (Wilks' lambda) was used, and in order to determine the effect size, the partial eta² test (η²) was used. According to the findings, administering dexamethasone both before and after a caesarean section prevented blood pressure from dropping. The results also indicated a statistical significance for placebo at p ≤0.01 on hemodynamic markers including systolic blood pressure, DBP, and MAP during cesarean section. In contrast, there were no statistically significant effects of placebo at p ≤ 0.05 on heart rate, RR, SpO2, and body temperature during cesarean section. The size of the placebo effect on systolic blood pressure and MAP was moderate, with partial eta square values (0.60 and 0.59), respectively. Regarding DBP, SpO2 and body temperature, the effect size of placebo was small, with partial squared values (0.40, 0.22, 0.22), respectively. This study highlights the potential of dexamethasone as a beneficial adjunct in the management of spinal anesthesia-related complications, thereby improving the safety and comfort of parturient undergoing cesarean sections. future research should focus on, such as exploring different doses or comparing with other medications is recommended to confirm these findings and establish standardized protocols for the use of dexamethasone in this context.
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