High-dose dexamethasone after Caesarean delivery: promising signal or marginal gain?

Abstract

Low-dose intravenous dexamethasone reduces postoperative pain, opioid consumption, and postoperative nausea and vomiting compared with placebo after general and spinal anaesthesia. However, evidence of additional analgesic benefit from high-dose dexamethasone remains unconvincing, and data are lacking in obstetric patients. In this issue of the British Journal of Anaesthesia, a randomised clinical trial observed only modest benefits of high-dose compared with low-dose intravenous dexamethasone after elective Caesarean delivery. Further studies targeting personalised care in patients at particular risk of severe acute postoperative pain and persistent pain are required.