Abstract

Dexamethasone is a potent synthetic glucocorticoid that reduces nitric oxide- mediated vasodilation, increases sympathetic activity, elevates catecholamine levels, and increases vascular sensitivity to vasopressors. A one-time dose of 8mg was most often administered by researchers. The timing of administration varied from two hours prior to immediately before spinal placement. The peak effect of dexamethasone occurs 45 to 60 minutes after administration which suggests that immediate dosing may not provide maximal benefit. The most common adverse effects of steroids include hyperglycemia, immunosuppression, delirium, and perineal itching. Overall, the available literature supports the short-term safety of a single dose of dexamethasone in this particular setting. Besides hemodynamic stability, dexamethasone provides several other benefits such as prolonged sensory and motor block, reduced postoperative analgesic use, and decreased nausea, vomiting, and shivering. These additional benefits enhance the rationale of incorporating dexamethasone into a multimodal anesthetic. Dexamethasone may contribute to overall hemodynamic stability while also improving maternal comfort through reduction in nausea and vomiting. Most studies have found that dexamethasone reduces the incidence of spinal-induced hypotension. Despite the positive results of most studies, some found no statistically significant decrease in hypotensive episodes. These conflicting findings may be attributed to sample size as well as variations in dose and timing of administration. Collectively, these results suggest that there is mixed evidence regarding the role of dexamethasone as an effective prophylactic adjunct to mitigate spinal-induced hypotension. Despite variability, the overall benefits outweigh the risks, as it is safe, well tolerated, and contributes to improved maternal comfort and hemodynamic stability. A single dose of dexamethasone is safe and may enhance hemodynamic stability and maternal comfort during cesarean section under regional anesthesia. Dexamethasone should be used as an adjunct not as the sole measure within a multimodal prophylaxis protocol including left uterine displacement, fluid co-loading, vasopressor administration.

Author Details

Virginia Nelsen, DNP(c), BSN; Nancy Westbrook, DNP MSNA CRNA FNP COL (Ret) USAF

Sigma Membership

Non-member

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Case Study/Series

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Dexamethasone -- Administration and Dosage, Dexamethasone, Spinal Anesthesia, Cesarean Section

Advisor

Terri M. Cahoon

Degree

DNP

Degree Grantor

Samford University

Degree Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

Date of Issue

2026-03-19

Full Text of Presentation

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Additional Files

Abstract.pdf (95 kB)

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