Anästhesie und klinische Forschung
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Intravenous Dexamethasone Causes Perineal Pain and Pruritus

Manpreet Singh, Chavi Sarabpreet Sharma, Rajesh S Rautela and Akhil Taneja

Background: Dexamethasone has been used for postoperative nausea and vomiting (PONV). Single dose dexamethasone in premedication does not cause any side effect. During our previous published study conducted on effect of dexamethasone for PONV, an unusual side effect of excruciating pain and perineal itching immediately following administration of this drug was observed. The present prospective incidence study was conducted in tertiary hospital of East Delhi, India to find out incidence and management of severe perineal pain and perineal pruritus immediately post-administration of dexamethasone.

Methods: 30 ASA 1 or 2 males (Group 1) and 30 ASA 1 or 2 females (Group 2) patients were selected to find incidence and intensity of pain after dexamethasone administration in both sexes posted for routine ophthalmologic, ENT and gastrointestinal surgeries. An intravenous canula (18 G) was inserted ringer lactate fluid was started. Dexamethasone in dose of 0.15 mg/kg was administered (after dilution with normal saline to 5 ml volume) along with i.v. fluid. Immediately patients were asked for any discomfort, pain/pruritus. Onset of pain & duration of pain was noted. Intensity of pain was assessed with 11 point Numeric pain scale and Simple descriptive pain intensity scale and Chi-Square test was applied with P value of <0.05 was considered as significant. Any other adverse effect was noted, if any.

Results: Seventy percent male patients suffered no pain as compared to 43.3% female patients (p<0.05). Only 30% male patients had suffered pain as compared to 56% female patients with similar perineal pruritus incidence and similar mean pain/pruritus onset time. The mean duration of persistence of pain was 23 seconds and 29 seconds in group 1 and 2 respectively.

Conclusion: Perineal itching or excruciating pain in patients receiving dexamethasone is more common in female patients with incidence more than 55%. The pain subsides on its own without any treatment.