Dexamethasone to Prevent Side Effects of Spinal Anesthesia in Cesarean Delivery

Evaluation of the Effectiveness of Intravenous Dexamethasone in Preventing Adverse Effects of Spinal Anesthesia in Parturients Undergoing Cesarean Delivery

The goal of this clinical trial is to evaluate the effectiveness of intravenous dexamethasone in preventing adverse effects of spinal anesthesia and prolonging postoperative analgesia in parturients undergoing elective cesarean delivery.

The main questions it aims to answer are:

Does intravenous dexamethasone reduce the incidence of post-spinal hypotension?

Does intravenous dexamethasone reduce the incidence of postoperative nausea and vomiting (PONV)?

Does intravenous dexamethasone prolong the duration of postoperative analgesia?

Researchers will compare intravenous dexamethasone (8 mg) to a placebo (0.9% saline) to see if dexamethasone effectively prevents post-spinal hypotension and PONV, and improves postoperative pain relief.

Participants will:

Receive an intravenous injection of either 8 mg dexamethasone or a placebo (2 mL 0.9% saline) prior to receiving spinal anesthesia.

Have their blood pressure recorded frequently (every minute for the first 20 minutes, then every 5 minutes until the completion of surgery).

Undergo sensory block assessment (via cold testing) and motor block evaluation (using the Bromage scale).

Have maternal glycemia and neonatal safety monitored for potential steroid-related adverse effects.

Inclusion Criteria:

• Age ≥ 18 years
• Singleton pregnancy
• Gestational age ≥ 37 weeks
• American Society of Anesthesiologists (ASA) physical status classification of II-III
• Planned for elective cesarean delivery under spinal anesthesia

Exclusion Criteria:

• Gestational diabetes mellitus or pre-existing (chronic) diabetes mellitus
• Gestational hypertension or chronic hypertension
• Body mass index (BMI) ≥ 35 kg/m²
• Known allergy to dexamethasone
• Current long-term corticosteroid therapy
• Diagnosis of postpartum hemorrhage