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Efficacy of preoperative dexamethasone in patients with laparoscopic cholecystectomy: a prospective randomized double-blind study

Journal of Hepato-Biliary-Pancreatic Surgery volume 16, Article number: 367 (2009) Cite this article

Abstract

Background/Purpose

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.

Methods

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.

Results

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).

Conclusions

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.

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Affiliations

  1. Department of Surgery, Shizuoka Saiseikai General Hospital, Shizuoka, 422-8527, Japan

    Yasuyuki Fukami, Masaki Terasaki, Yoshichika Okamoto, Kenji Sakaguchi, Toru Murata, Masayuki Ohkubo & Kazumi Nishimae

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  1. Yasuyuki Fukami
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  2. Masaki Terasaki
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  3. Yoshichika Okamoto
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  4. Kenji Sakaguchi
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  5. Toru Murata
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  6. Masayuki Ohkubo
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  7. Kazumi Nishimae
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Correspondence to Yasuyuki Fukami.

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Fukami, Y., Terasaki, M., Okamoto, Y. et al. Efficacy of preoperative dexamethasone in patients with laparoscopic cholecystectomy: a prospective randomized double-blind study. J Hepatobiliary Pancreat Surg 16, 367 (2009). https://doi.org/10.1007/s00534-009-0079-5

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  • DOI: https://doi.org/10.1007/s00534-009-0079-5

Keywords

  • Laparoscopic cholecystectomy
  • Dexamethasone
  • PONV
  • Complications