Radiation safety for anaesthesia providers

followed all the elements of the CONSORT checklist and reported the CONSORT flow diagram, with the exception of two elements that we would like to clarify here. The study was conducted at Duke University Medical Center in Durham, NC, USA. There was no patient enrollment in Chile; Dr. Lacassie was involved with the study whilst at Duke University Medical Center. The trial was not registered on a public registry, because there was no requirement for registration when the trial started in 2005. Anaesthesia requested registration details during the submission process. The outcome measures of the trial did not deviate from those determined a priori, and are typical for studies investigating changes in postoperative glucose concentrations from baseline. The 8 mg dose of dexamethasone used in our trial was commonly used for postoperative nausea and vomiting (PONV) at the time we started our study. The consensus guidelines for the management of PONV that were published in 2003 recommended a dose of 5–10 mg [2]. This was subsequently reduced to 4–5 mg in the guidelines published in 2007 and 2014 [3, 4]. While we agree that there does not appear to be a difference in anti-emetic efficacy between the 4 and 8 mg doses of dexamethasone [5], there might still be reasons to use the 8 mg dose in current practice. For instance, improved quality of recovery scores and enhancement of postoperative analgesia have been reported with the use of the higher dose of dexamethasone [6, 7]. The increase in blood glucose following dexamethasone administration might be dose dependent. Our group has recently reported a smaller increase in postoperative blood glucose concentration with a 4 mg dose compared to the 8–10 mg dose of dexamethasone [8]. Therefore, as we stated in our article, the 4 mg dose might be preferred if dexamethasone was used for PONV prophylaxis in diabetic patients.