Comparison of the Effects of Low-Dose versus Standard-Dose Intravenous Dexamethasone on Acute Pain during the First Six Hours after Laminectomy

Introduction: Postoperative pain following lumbar laminectomy can be intense and challenging to manage. Intravenous dexamethasone is commonly used as part of multimodal analgesia, but optimal dosing remains unclear. This study aimed to compare the effects of low-dose and standard-dose dexamethasone on acute pain, opioid use, and postoperative nausea and vomiting (PONV) in the early postoperative period.Materials and Methods: In this double-blind randomized controlled trial conducted at Tabriz University of Medical Sciences, ۷۰ patients undergoing elective single-level lumbar laminectomy were randomized to receive either ۴ mg (low-dose) or ۸ mg (standard-dose) of intravenous dexamethasone before incision. Pain intensity (VAS), morphine consumption, and PONV incidence were assessed during the first six hours postoperatively. Blood glucose levels and adverse effects were also monitored.Results: Patients in the standard-dose group had significantly lower VAS scores at all time points (p < ۰.۰۱) and reduced morphine use (p = ۰.۰۰۳). PONV incidence was also lower (p = ۰.۰۴۸). Blood glucose levels were slightly higher in the standard-dose group (p = ۰.۰۲۱), but remained within safe limits.Conclusion: Standard-dose dexamethasone (۸ mg) is more effective than low-dose (۴ mg) for early postoperative pain control and PONV reduction, with acceptable short-term safety.

Keywords:

dexamethasone , Laminectomy , Postoperative pain , randomized controlled trial