Maternal and newborn impact of epidural dexamethasone as an adjuvant for labor analgesia: A meta-analysis
- Author:
Crista Mae F. Fontanilla
;
Joy Ann R. Lim
- Publication Type:Journal Article
- Keywords:
Epidural;
Labor analgesia
- MeSH:
Dexamethasone;
Meta-Analysis
- From:
The Philippine Children’s Medical Center Journal
2023;19(2):32-55
- CountryPhilippines
- Language:English
-
Abstract:
Background:Dexamethasone, an anti-inflammatory drug, has an assumed analgesic effect
when given epidurally, with less side effects5,7. Although numerous studies have evaluated
dexamethasone, there is a paucity of studies assessing its intrapartum use.
Objectives:To determine the effectiveness of epidural dexamethasone when used as an
adjuvant for labor analgesia.
Materials and Methods:A meta-analysis guided by the Cochrane handbook was
performed. Articles were searched through PubMed, MEDLINE, CENTRAL, Google Scholar and
ClinicalTrials.gov using search strategies such as keywords and MeSH terms. Cochrane version 2
risk-of-bias tool for randomized trials (RoB 2) was used to assess for quality. Quantitative data
were pooled and analyzed using Review Manager 5.4.1.
Results:A total of five trials involving 309 women in labor were analyzed. The pooled mean
difference showed prolonged duration of epidural analgesia on patients who received epidural
dexamethasone; pooled risk ratio between the experimental and control group demonstrated no
significant maternal adverse events such as nausea and vomiting, shivering, hypotension, and
fever. Pooled risk ratio and mean difference also showed that epidural dexamethasone had no
significant effect on the neonatal APGAR and neonatal umbilical pH.
Conclusion:Present data demonstrated the potential role of dexamethasone as an adjuvant
to epidural solution during labor analgesia on providing local anesthetic dose sparing effect
through prolongation of the duration of epidural analgesia, with limited maternal and neonatal
adverse events. These results should be interpreted with caution before adopting this technique in
routine clinical practice.
- Full text:pcmc 3.pdf
