Effect of Dexamethasone on Postoperative Symptoms in Patients Undergoing Elective Laparoscopic Cholecystectomy: Randomized Clinical Trial
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- Sánchez-Rodríguez, PE., Fuentes-Orozco, C. & González-Ojeda, A. World J Surg (2010) 34: 895. doi:10.1007/s00268-010-0457-9
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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.