Comparison of Lignocaine-Dexamethasone vs. Lignocaine-Triamcinolone for Preventing Post Spinal-Epidural Backache: A Randomized Study

Background: The primary objective of this study was to compare the efficacy of lignocaine-dexamethasone and lignocaine-triamcinolone infiltration, along the spinal-epidural needle insertion pathway, to prevent backache after lower abdominal surgeries.

Methods: This prospective, double-blind randomized controlled study included a total of 150 patients, scheduled for elective lower abdominal surgery under combined spinal-epidural (CSE) anaesthesia. The patients were randomised into three groups Group L (Lignocaine, n=50), Group DL (Dexamethasone, Lignocaine, n=50), and Group TL (Triamcinolone, Lignocaine, n=50).

Results: The Visual Analogue Score (VAS) was used to assess the postoperative pain. The anthropometric and demographic findings were comparable among the three groups. The mean VAS score at the time points of needle placement and at postoperative time periods of 24 hours, 48 hours, 72 hours, one month, two months and three months were significantly lower (p<0.001) in groups DL and TL compared to group L.

Conclusion: This study demonstrated that the addition of a steroid like triamcinolone or dexamethasone with lignocaine for local infiltration along the spinal-epidural tract significantly lowers the severity of post-needle puncture backache in comparison to lignocaine alone in lower abdominal surgeries.