Dexamethasone (9-fluoro-11β, 17, 21-trihydroxy-16α-methylpregna-1, 4-diene-3, 20-dione) vs Pethidine (ethyl 1-methyl-4-phenylpiperidine-4-carboxylate) for Post-Thoracotomy Analgesia: Systematic Review

The objective of this systematic review is to assess and contrast the effectiveness and safety of dexamethasone in comparison to pethidine for post-thoracotomy pain management. Through a comprehensive synthesis of existing evidence, the review intends to offer valuable perspectives on the preferred analgesic options for individuals undergoing this surgical procedure.

An exhaustive exploration of the literature will be undertaken through electronic databases, encompassing PubMed, Embase and the Cochrane Library. The search approach will integrate pertinent keywords and Medical Subject Headings (MeSH) terms like "dexamethasone,",” ethyl 1-methyl-4-phenylpiperidine-4-carboxylate”, “ 9-fluoro-11β,17,21-trihydroxy-16α-methylpregna-1,4-diene-3,20-dione”, "pethidine," "thoracotomy," and "postoperative pain." The search scope will be restricted to articles available in the English language.

Pain intensity scores were evaluated using various pain scales, including the VAS and NRS. Five studies reported pain intensity scores as an outcome measure. Among these, three studies favored dexamethasone, showing significantly lower pain intensity scores in the dexamethasone group compared to the pethidine group.

based on the available evidence, dexamethasone appears to offer potential advantages over pethidine for post-thoracotomy analgesia in terms of pain control and opioid consumption. The choice between dexamethasone and pethidine should consider individual patient characteristics, risk factors, and the surgeon's preference.