Efficacy of preoperative dexamethasone in patients with laparoscopic cholecystectomy: a prospective randomized double-blind study
ABSTRACT Dexamethasone has been reported to reduce postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy (LC). However, its effect on other surgical outcomes such as pain and fatigue have been unclear. The purpose of this clinical study was to evaluate the efficacy of preoperative dexamethasone in ameliorating postoperative symptoms after LC.
In this prospective, double-blind, placebo-controlled study, 80 patients scheduled for LC were analyzed after randomization to intravenous dexamethasone (8 mg) or placebo. All patients underwent standardized procedures for general anesthesia and surgery, and were recommended to remain in hospital for 3 postoperative days. Episodes of PONV, and pain and fatigue scores on a visual analogue scale (VAS) were recorded. Analgesic and antiemetic requirements were also recorded.
There were no apparent side effects of the study drug. Seven patients (18%) in the dexamethasone group reported nausea, compared with 16 (40%) in the placebo group (p = 0.026). One patient (3%) in the dexamethasone group and 7 (18%) in the placebo group reported vomiting (p = 0.025). Dexamethasone significantly reduced the postoperative VAS pain score (p = 0.030) and VAS fatigue score (p = 0.023). The mean number of patients requiring diclofenac sodium 50 mg was 0.9 +/- 1.3 in the dexamethasone group and 2.2 +/- 2.5 in the placebo group (p = 0.002).
The regimen we employed is safe and without apparent side effects. These results suggest that preoperative dexamethasone (8 mg) significantly reduces the incidence of PONV, pain, and fatigue after LC.
- SourceAvailable from: Mohammad Ali Hessami[Show abstract] [Hide abstract]
ABSTRACT: Post-operative nausea and vomiting (PONV) is one of the common problems after laparoscopic cholecystectomy. The current study aimed to compare Dexamethasone effect with that of Granisetron in prevention of PONV. In the current study 104 patients aged 20-60 with ASA class I or II who were candidates for laparoscopic cholecystectomy were included in the study. Patients were randomly divided into two groups of A and B. 15 minutes before anesthesia induction, in group a patient's 3 mg Granisetron and in group B patients 8 mg Dexamethasone was intravenously injected. Then both groups underwent general anesthesia with similar medications. After operation the prevalence of nausea and vomiting was assessed at three time intervals (0-6 hours, 6-12 hours and 12-24 hours after consciousness). SPSS software version 16 was employed to analyze data. T test, chi-square test and Fischer exact test were performed level of significance was P < 0.05. There was no significant difference between age, gender proportion, weight, height, and body mass index (BMI) of patients in the two groups. In Dexamethasone group, seven patients experienced nausea and three patients had vomiting, and in Granisetron group, five patients experienced nausea and three patients had vomiting after consciousness. Statistical analysis indicated no significant difference between the two groups in this regard. Intravenous injection of 8 mg Dexamethasone or 3 mg Granisetron before anesthesia induction had similar effects in prophylaxis of nausea and vomiting after laparoscopic cholecystectomy.09/2012; 2(2):81-4. DOI:10.5812/aapm.6945
- Zentralblatt für Chirurgie 02/2010; 135(02). DOI:10.1055/s-0030-1247332 · 1.19 Impact Factor
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ABSTRACT: Single dose intravenous dexamethasone as sole agent or in combination with other antiemetics has become well-accepted for prophylaxis against postoperative nausea and vomiting. There is also increasing support for effects on pain and general well-being. Single dose 8–15 mg dexamethasone intravenously has been shown to improve the recovery process in ambulatory surgery in adults. It has also been shown to facilitate the recovery in children undergoing adeno/tonsillectomy. The effects on blood glucose must be acknowledged and the potential effect on the healing process deserves further studies.Le Praticien en Anesthésie Réanimation 09/2011; 15(4):230-238. DOI:10.1016/j.pratan.2011.05.008