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标题：Effect of dexamethasone on reducing painandgastrointestinal symptoms associated with cesarean section:a systematic review and meta-analysis
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作者：Mohamed Abdelmonem ; Fatma M.Sayed ; Omar M Mohammed 等
期刊名称：Proceedings in Obstetrics and Gynecology
印刷版ISSN：2154-4751
出版年度：2021
卷号：10
期号：2
页码：1-25
DOI：10.17077/2154-4751.1517
语种：English
出版社：University of Iowa
摘要：Dexamethasone has analgesicandantiemetic actions that have been documented in the literature. Therefore, we performed a systematic reviewandmeta-analysis to investigate its overall effectiveness in reducing a variety of negative outcomes after cesarean section. Objectives: To investigate the efficacyandsafety of dexamethasone for reducing pain associated with cesarean section, nausea, vomiting, pruritus, postoperative need for analgesia, postoperative antiemetic requestsandheadache. Methods: We searched PubMed, Cochrane CENTRAL, SCOPUS,andWeb of Science for relevant clinical trials. We then performed a systematic reviewandmeta-analysis, including only randomized, placebo-controlled clinical trials. Our main population target was women undergoing elective cesarean delivery. The intervention under consideration was dexamethasone administered both by intravenous (IV) or subcutaneous (SC) over a variety of doses. The comparator was a placebo. Our main outcomes included: (1) perceptions as indicated by pain scores, (2) occurrence of nauseaand(3) occurrence of vomiting. Secondary outcomes included: (4) occurrence of pruritus, (5) need for postoperative analgesia, (6) need for postoperative antiemetic drugsand(7) occurrence of headache. We assessed the quality of included studies using the risk of bias tool described in Cochrane's handbook for systematic reviews of interventions. Results: We found that dexamethasone seemed to significantly reduce scores for pain at rest (p<0.001), as well as occurrence of nausea (p<0.001)andvomiting (p<0.001). The drug also showed significant reduction of negative symptoms in other secondary outcomes, including need for postoperative analgesia (p<0.001)andpostoperative antiemetic drugs (p<0.001). However, the drug showed no significant effect in reducing headacheandpruritus or in improving pain at movement scores. Conclusion: Dexamethasone appears to decrease perception of pain at restandprotects against nauseaandvomiting. However, it does not seem effective against headaches or pruritus.
关键词：Dexamethasone;cesarean;pain;nausea;vomiting