Efficacy and safety of dexamethasone in preventing intraoperative hypotension, nausea and vomiting in caesarean sections under spinal anaesthesia in Mulago Hospital: A double blind clinical trial.

Abstract

Introduction: Hypotension is one of the most common and feared side effect of spinal anesthesia among parturients undergoing caesarean section which may compromise the wellbeing of both the mother and the fetus. Severe hypotension following spinal anesthesia is a dangerous complication which if unnoticed or inadequately treated, can lead to serious maternal or fetal compromise. There is therefore the need for an interventional study geared to prevent or reduce the incidence of hypotension, nausea and vomiting following spinal anesthesia for caesarean section at Mulago. Methodology: The study was a randomized double blinded placebo controlled clinical trial conducted in Mulago hospital obstetric theatres,(PCTR20132000577386). All patients admitted to Mulago labor ward ceaserean section under spinal anaesthesia, with informed consent were included. Objectives: To determine incidence of intra-operative hypotension, nausea and vomiting in parturients receiving a preoperative bolus of dexamethasone verses the placebo under spinal anesthesia in Mulago hospital. Results: Hypotension was observed in both groups. Of the 88 patients in the placebo group, 61(69.32%) developed hypotension compared to 43(48.86%) in the dexamethasone group. There was a statistical difference in the occurrence of hypotension between the two treatment groups. (P-value =0.006) Conclusions: Dexamethasone reduced occurrence of spinal hypotension by 30%. There was no statistical difference in the occurrence of nausea, vomiting between the two groups.