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Efficacy of preoperative dexamethasone in patients with laparoscopic cholecystectomy: a prospective randomized double‐blind study
Author(s) -
Fukami Yasuyuki,
Terasaki Masaki,
Okamoto Yoshichika,
Sakaguchi Kenji,
Murata Toru,
Ohkubo Masayuki,
Nishimae Kazumi
Publication year - 2009
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-009-0079-5
Subject(s) - medicine , dexamethasone , anesthesia , placebo , visual analogue scale , nausea , postoperative nausea and vomiting , antiemetic , analgesic , vomiting , cholecystectomy , retching , surgery , alternative medicine , pathology
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.