الفهرس 
Introduction and Aim of the workOnly 14 pages are availabe for public view
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Abstract
This prospective, randomized and double blinded study was conducted at EL-Minia University Hospital during the period from September 2015 to Febuary 2016, the study involved 60 patients full term parturient women, aged between 19- 40 years old, ASA II , had singleton pregnancy with vertex presentation with cervical dilatation of 4−7 cm who were willing for epidural analgesia during normal labor.
Patients were randomly divided into two equal groups; group A (dexamethasone group, n=30) received 16 mL solution containing local anesthetics and fentanyl plus 8mg dexamethasone . group B (control group, n=30) received 16 mL solution containing local anesthetics and fentanyl only.
The aim of this study was to evaluate Evaluation of the efficacy of addition of dexamethasone with bupivacaine and fentanyl for epidural analgesia in normal labor on onset and duration of local anesthetic action and number of top up doses.
All patients were assessed with regards to:
Hemodynamics (heart rate, MAP) and oxygen saturation were recorded just before the epidural induction as a baseline value, immediately after the block 10, 20, 30,40,50, 60, 75,90 and100 minutes during the delivery time and 10, 20, 30min after top up doses.
Onset time of sensory block, Onset time of motor block, Duration of sensory block, and Duration of motor block was assessed in minutes.
Pain assessment using a scoring system based on the (VAS) scale consisting of (best to worst: 0 – 10 cm). VAS is measured at the following time intervals 10,
30,50,70,90 and 110 min. time to first top up dose requirement (in minutes) was continuously monitored in the two groups.
The incidence of adverse effects whether related to the drugs used in the technique or related to the technique itself were recorded.
The results of this study found that demographic (age, gravidity, weight, height and cervical dilatation ) was statistically insignificant between the two groups of patients.
Hemodynamics (HR and MAP) and oxygen saturation were statistically insignificant between the two groups at all-time intervals .
As regard duration of sensory block in dexamethasone group was clinically and significantly longer than control group. While for the onset time of sensory block, there was no statistically significant differences (P > 0.05) between the two groups.
As regard to number of top up doses in dexamethasone group was clinically and significantly lesser than control group
For Visual Analogue Scale (VAS), while comparing the two groups, the differences were significant at 70 and 90 min after epidural induction for the favor of the dexamethasone group. But there were not statistically significant differences between the two groups in VAS at all other time intervals.
Patient satisfaction score was clinically higher in dexamethasone group patients than control group patients.
As regard to complications,there were statistically insignificant between the two groups.