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Journal of Anesthesia

, Volume 30, Issue 6, pp 941–948 | Cite as

The effect of single low-dose dexamethasone on vomiting during awake craniotomy

  • Kotoe KamataEmail author
  • Nobutada Morioka
  • Takashi Maruyama
  • Noriaki Komayama
  • Masayuki Nitta
  • Yoshihiro Muragaki
  • Takakazu Kawamata
  • Makoto Ozaki
Original Article
  • 388 Downloads

Abstract

Purpose

Intraoperative vomiting leads to serious respiratory complications that could influence the surgical decision-making process for awake craniotomy. However, the use of antiemetics is still limited in Japan. The aim of this study was to investigate the effect of prophylactically administered single low-dose dexamethasone on the incidence of vomiting during awake craniotomy. The frequency of hyperglycemia was also examined.

Methods

We conducted a retrospective case review of awake craniotomy for glioma resection between 2012 and 2015.

Results

Of the 124 patients, 91 were included in the analysis. Dexamethasone was not used in 43 patients and the 48 remaining patients received an intravenous bolus of 4.95 mg dexamethasone at anesthetic induction. Because of stable operating conditions, no one required conscious sedation throughout functional mapping and tumor resection. Although dexamethasone pretreatment reduced the incidence of intraoperative vomiting (P = 0.027), the number of patients who complained of nausea was comparable (P = 0.969). No adverse events related to vomiting occurred intraoperatively. Baseline blood glucose concentration did not differ between each group (P = 0.143), but the samples withdrawn before emergence (P = 0.018), during the awake period (P < 0.0001) and at the end of surgery (P < 0.0001) showed significantly higher glucose levels in the dexamethasone group. Impaired wound healing was not observed in either group.

Conclusion

A single low-dose of dexamethasone prevents intraoperative vomiting for awake craniotomy cases. However, as even a small dose of dexamethasone increases the risk for hyperglycemia, antiemetic prophylaxis with dexamethasone should be administered after careful consideration. Monitoring of perioperative blood glucose concentration is also necessary.

Keywords

Awake craniotomy Dexamethasone Vomiting Intraoperative complications 

Notes

Acknowledgments

We thank Satoshi Hagihira, MD, Department of Anesthesiology, and Surgical Center, Osaka Prefectural Osaka General Medical Center, Osaka, Japan, for invaluable help in the execution of the study.

Compliance with ethical standards

Conflict of interest

The present research was supported solely by hospital and/or departmental sources. None of the authors have any financial interests in products related to this study.

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Copyright information

© Japanese Society of Anesthesiologists 2016

Authors and Affiliations

  • Kotoe Kamata
    • 1
    Email author
  • Nobutada Morioka
    • 1
  • Takashi Maruyama
    • 2
    • 3
  • Noriaki Komayama
    • 1
  • Masayuki Nitta
    • 2
    • 3
  • Yoshihiro Muragaki
    • 2
    • 3
  • Takakazu Kawamata
    • 2
  • Makoto Ozaki
    • 1
  1. 1.Department of AnesthesiologyTokyo Women’s Medical UniversityTokyoJapan
  2. 2.Department of Neurosurgery, Neurological InstituteTokyo Women’s Medical UniversityTokyoJapan
  3. 3.Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and ScienceTokyo Women’s Medical UniversityTokyoJapan

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