Background:	The analgesic properties of dexamethasone have not been tested in major surgery and the optimal dose of dexamethasone to reduce postoperative pain has also not been established. This study evaluated dose dependent efficacy of dexamethasone in major surgery.
Method:  This is a double blind randomized controlled trial. Patients were allocated into one of the following groups: Normal saline (Group 1), Dexamethasone 0.15mg/kg (Group 2) and Dexamethasone 0.3 mg/kg (Group 3) at induction of anaesthesia. All patients underwent standardized general anaesthesia. Postoperative pain was managed by patient controlled analgesia with morphine. All patients were followed up to 24 hours postoperatively, patient pain scores (VAS) and morphine consumption was recorded at recovery room, at 4 hour and at 24 hour post-surgery.
Results:  37 patients who were scheduled for major surgical procedures were enrolled; 13 patients each in Groups 1 and 2 and 11 patients in Group 3. There was a statistically significant decrease in pain scores in the recovery room (p=0.011) and at 4-hours post-surgery both at rest (p=0.013) and movement (p=0.035) with the usage of dexamethasone 0.3 mg/kg dose at induction, but there was no such effect with dexamethasone 0.15 mg/kg. This study did not show significant difference in pain scores at 24-hours with dexamethasone. Dexamethasone did not show significant difference in the overall opioid consumption when used in major surgery.
Conclusions:  High dose dexamethasone 0.3 mg/kg had significant effect on early postoperative pain up to 4 hour post-surgery, in major surgical procedures. Dexamethasone did not show any significant effect on postoperative opioid consumption.

EFFECT OF SINGLE-DOSE DEXAMETHASONE ON ACUTE POSTOPERATIVE PAIN AFTER MAJOR SURGERY