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Dexamethasone before total laparoscopic hysterectomy: a randomized controlled dose-response study.

Author(s): Thangaswamy CR, Rewari V, Trikha A, Dehran M, Chandralekha

Affiliation(s): Department of Anaesthesiology and Intensive Care, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.

Publication date & source: 2010-02, J Anesth., 24(1):24-30. Epub 2010 Jan 6.

Publication type: Randomized Controlled Trial; Research Support, Non-U.S. Gov't

PURPOSE: A prospective, randomized, double blind, placebo-controlled study was undertaken to evaluate the efficacy of a single preoperative dose of dexamethasone, in different dosages, in providing postoperative analgesia in patients undergoing total laparoscopic hysterectomy (TLH). METHOD: The study included 55 patients randomly divided into three groups. Patients in Groups P, D4, and D8 received saline, 4, and 8 mg dexamethasone, respectively, intravenously, 2 h before induction. RESULTS: The time to first analgesic requirement was significantly delayed in patients in the D8 group compared with the D4 group (P = 0.01) and placebo (P = 0.01). Total postoperative fentanyl consumption was significantly less in patients in the D8 group compared with the D4 group (P = 0.01) and placebo (P = 0.01). Use of 8 mg dexamethasone resulted in a 99.3 mcg decrease in total 24-h fentanyl consumption. Postoperative nausea and vomiting (PONV) was significantly less in the D8 group with a complete response rate (no emetic episodes and no rescue medication for 24 h) of 36.8% compared with the placebo group in which all the patients had PONV. No adverse effects were observed in any group. CONCLUSION: Dexamethasone at a dose of 8 mg given intravenously 2 h before induction, delays patient request for analgesia and reduces total fentanyl consumption and PONV in patients undergoing TLH.

Page last updated: 2010-10-05

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