Intravenous Dexamethasone Reduces Pain in Middle Ear Surgery

Few studies evaluated the treatment of postoperative pain in middle ear surgery.

We conducted a randomized clinical trial to evaluate the efficacy of dexamethasone in the management of postoperative pain in middle ear surgery. Group G1 received an intravenous injection of 2 ml of physiological saline 30 minutes before the end of the procedure. Group G2 received a 2 ml intravenous solution containing 8 mg of dexamethasone, 30 minutes before the end of the procedure. Pain perception was measured by the Visual analog scale (VAS) every 10 min during the first hour and then every 6 hours during the 24 hours postoperatively. The delay of the first analgesic demand and the consumption of analgesics use during the first 24 hours postoperatively, were recorded.

VAS values were lower in G2at all measurement points during the first hour, as well as the first 24h postoperatively (Mann-Whitney test, P<0.05).The delay of the analgesic request was (0 (0-60) for G1 versus 0 (0-80) for G2, P=0.04, Mann-Whitney test). Morphine was used in 44% of the patients in G1 against 19% for G2 (P = 0.031). There was a significant difference between G1 and G2 in terms of the total dose of morphine consumed (P= 0.028, Mann-Whitney test). Paracetamol demand was lower in group 2 at all points of assessment during the first 24 hours postoperatively.

Intravenous dexamethasone is effective in decreasing pain and analgesic requirement, during the first 24 hours postoperatively, in patients undergoing middle ear surgery.