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Preoperative High Dose of Methylprednisolone Improves Early Postoperative Pulmonary Function, in Super-Obese Patients Undergoing Open Surgery; a Prospective, Comparative Study

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Surgery stimulates an intense systemic inflammatory response which might increase postoperative morbidity. Corticosteroids may reduce this inflammatory reaction. The purpose of this study was to investigate any possible effect on postoperative morbidity and recovery after administrating methylprednisolone in super-obese patients undergoing open surgery.

Methods

Sixty super-obese patients with BMI ≥50 kg/m2 (mean 57.48 ± 7.33), mean age of 39 ± 9 years, who underwent an open bariatric procedure, were enrolled. Thirty patients (group A) were allocated to a preoperative single dose of 30 mg/kg (ideal body weight) methylprednisolone versus placebo (group B, 30 patients). Endpoints included assessment of IL-6 and CRP; evaluation of postoperative pulmonary function, pain management, nausea, and vomiting; and documentation of postoperative complications.

Results

Significant improvement in spirometry parameters and arterial blood gas analysis, in the first and third postoperative days, was observed in the methylprednisolone group. IL-6 and CRP levels were significantly lower in that group. Administration of methylprednisolone was associated with less postoperative pain, nausea, and vomiting, with no statistical difference in septic complications.

Conclusions

Preoperative administration of a single high dose of methylprednisolone in super-obese patients undergoing open surgery inhibits the inflammatory signaling cascade, lessens the systemic inflammatory response, and results in fewer pulmonary complications and better patient recovery.

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Author Contributions

All the abovementioned coauthors met all the criteria for authorship contribution of the International Committee of Medical Journal Editors (ICMJE)

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Authors and Affiliations

  1. Morbid Obesity Unit, Department of Surgery, University Hospital of Patras, Rion Patras, 26504, Patras, Greece

    George Skroubis, George Theofanis, Charalampos Spyropoulos & Fotis Kalfarentzos

  2. Department of Anesthesiology and Critical Care Medicine, University Hospital of Patras, Patras, Greece

    Anastasia Zotou

  3. University Hospital of Patras, Patras, Greece

    Petros Constantinopoulos

  4. Division of Endocrinology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece

    Theodore Alexandrides

Authors
  1. George Skroubis
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  2. George Theofanis
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  3. Charalampos Spyropoulos
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  4. Anastasia Zotou
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  5. Petros Constantinopoulos
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  6. Fotis Kalfarentzos
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  7. Theodore Alexandrides
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Corresponding author

Correspondence to George Skroubis.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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The authors declare that they have no conflict of interest

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Skroubis, G., Theofanis, G., Spyropoulos, C. et al. Preoperative High Dose of Methylprednisolone Improves Early Postoperative Pulmonary Function, in Super-Obese Patients Undergoing Open Surgery; a Prospective, Comparative Study. J Gastrointest Surg 20, 1959–1965 (2016). https://doi.org/10.1007/s11605-016-3281-1

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  • DOI: https://doi.org/10.1007/s11605-016-3281-1

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