Date: 12 Feb 2010
Effect of Dexamethasone on Postoperative Symptoms in Patients Undergoing Elective Laparoscopic Cholecystectomy: Randomized Clinical Trial
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Dexamethasone has been reported to reduce postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy (LC). However, its effects on other surgical outcomes, such as pain and fatigue, have been unclear. We evaluated the efficacy of preoperative dexamethasone for ameliorating postoperative symptoms after LC.
In this prospective, double-blind, placebo-controlled study, 210 patients scheduled for elective LC were analyzed after randomization to intravenous dexamethasone (8 mg) or a placebo. All patients underwent standardized procedures for general anesthesia and surgery. Episodes of PONV and the pain and fatigue scores were recorded on a visual analog scale. Analgesic and antiemetic requirements were also recorded.
There were no significant differences between groups with regard to medical or demographic variables. Significantly fewer patients experienced PONV in the dexamethasone group immediately after LC and at 6 and 12 h. The need for ondansetron to relieve PONV was higher in the placebo group (P = 0.001). Patients in the study group reported less postoperative pain during the first 24 h and less fatigue after 6, 12, and 24 h. The need for buprenorphine to relieve intolerable pain was also less in this group (P = 0.009). There were no side effects, and the morbidity was similar in the two groups (6.7 vs. 7.6%).
The regimen we employed is safe and without apparent side effects. Thus, preoperative dexamethasone can significantly reduce the incidence of PONV, pain and fatigue after elective LC.
Wang JJ, Ho ST, Liu YH et al (1999) Dexamethasone reduces nausea and vomiting after laparoscopic cholecystectomy. Br J Anaesth 83:772–775PubMed
Aapro MS, Alberts DS (1981) Dexamethasone as an antiemetic in patients treated with cisplatin. N Engl J Med 305:520PubMed
Italian Group for Antiemetic Research (1995) Dexamethasone, granisetron, or both for the prevention of nausea and vomiting during chemotherapy for cancer. N Engl J Med 332:1–5CrossRef
Christensen T, Stage JG, Galbo H et al (1989) Fatigue and cardiac and endocrine metabolic response to exercise after abdominal surgery. Surgery 105:46–50PubMed
Fredman B, Jedeikin R, Olsfanger D et al (1994) Residual pneumoperitoneum: a cause of postoperative pain after laparoscopic cholecystectomy. Anesth Analg 79:152–154PubMed
Holte K, Kehlet H (2000) Perioperative single-dose glucocorticoid administration: pathophysiologic effects and clinical implications. J Am Coll Surg 195:694–712CrossRef
Zargar-Shostari K, Hill AG (2009) Postoperative fatigue: a review. World J Surg 33:738–745CrossRef
Bianchin A, De Luca A, Caminiti A (2007) Postoperative vomiting reduction after laparoscopic cholecystectomy with single dose of dexamethasone. Minerva Anestesiol 73:343–346PubMed
Fujii Y, Itakura M (2009) Reduction of postoperative nausea, vomiting and analgesic requirement with dexamethasone for patients undergoing laparoscopic cholecystectomy. Surg Endosc DOI 10.1007/s00464-009-0657-2. Published online August 19
- Effect of Dexamethasone on Postoperative Symptoms in Patients Undergoing Elective Laparoscopic Cholecystectomy: Randomized Clinical Trial
World Journal of Surgery
Volume 34, Issue 5 , pp 895-900
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors
- Author Affiliations
- 1. Department of Anesthesiology, Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Guadalajara, Jalisco, Mexico
- 2. Department of Anesthesiology, Regional Hospital #110, Western Medical Center, Mexican Institute of Social Security, Guadalajara, Jalisco, Mexico
- 3. Research Unit in Clinical Epidemiology, Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Guadalajara, Jalisco, Mexico
- 4. Calle José E. Rodo #2558, Colonia Prados Providencia, Guadalajara, Jalisco, 44670, Mexico