Intravenous Dexamethasone as an Analgesic: A Literature Review

The management of pain in surgical patients has shifted in recent years from a technique grounded in opioid administration, to a multimodal method that uses the analgesic properties of many drugs to minimize required narcotics. Multimodal analgesia has demonstrated a benefit in patient outcomes following a surgical procedure. Also of consideration is the fact that multimodal analgesia allows for less opioid to be administered to achieve acceptable pain scores, in turn reducing a patient's exposure to a potentially addicting substance. Dexamethasone is a corticosteroid that has been widely used in the perioperative setting to prevent postoperative nausea and vomiting. The analgesic properties of dexamethasone have not been as widely acknowledged. A review of literature was conducted. Multiple studies were found that demonstrated dexamethasone's ability to lower postoperative pain scores and reduce the amount of opioids required to achieve adequate pain scores. Single doses of dexamethasone have demonstrated safety with minimal side effects that would be expected from corticosteroid administration. Although an elevation in blood glucose levels is seen, this is likely of little clinical significance. No difference is seen in wound healing or rates of wound infection compared with control groups.