Periodicidad semestral: flujo continuo.
ISSN - Electrónico: 2661-6947 / DOI: 10.36015 • LILACS BIREME (19784); LATINDEX (20666)
Objectives: the aim of this study was to determine the efficacy and safety of perioperative dexamethasone to reduce postoperative pain and opioid consumption after surgery. Methods: a blinded randomized controlled trial was performed in ASA I and ASA II patients undergoing abdominal or pelvic surgery. Only patients in the A group received IV dexamethasone 0,2 mg/kg perioperative. Same analgesic and antiemetic drugs were given to the patients in both groups. We assessed pain level, nausea, vomiting (PONV) and use of rescue drugs in the postoperative period. Patients were followed during two weeks, after surgery, looking for adverse events like wound dehiscence or infection. Results: the group of 81 patients allocated to dexamethasone
reduced significantly the use of rescue drugs for pain and incidence of severe pain (RR: 0.48; p 0.009 and RR: 0.35; p 0.036). Wound infection incidence was equal in both groups. Conclusions: dexamethasone at 0.2 mg/kg perioperative in abdominal or pelvic surgery in ASA I and ASA II patients is safe and effective as an adjunct therapy to reduce postoperative pain and opioid consumption.
Zaragozá F, Landa I. Dolor post operatorio en España. Primer documento de consenso. Librería virtual, 2005.
White PF. Multimodal analgesia: Its role in preventing postoperative pain. Curr Opin Investig Drugs, 2008; 9:76 – 82
Hval K, Thagaard KS, Schlichting E. et. al. The Prolonged Postoperative Analgesic Effect When Dexamethasone Is Added to a Nonsteroidal Antiinflammatory Drug (Rofecoxib) Before Breast Surgery. Anesthesia & Analgesia, 105, No. 2, August 2007.
Alparslan T, Sessler D. Steroids to Ameliorate Postoperative Pain. Anesthesiology, 20110; 115(3) 457-459
Longstreth G, Hesketh P. Antihemetics. Up to date, 19.1; January, 2011.
De Oliveira, Jr. et. al. Perioperative Single Dose Systemic Dexamethasone for Postoperative Pain. A Meta-analysis of Randomized Controlled Trials. Anesthesiology, 2011; 115:575–588
Bisgaard T, Klarskov B, Kehlet H, Rosenberg J. Preoperative dexamethasone improves surgical outcome after laparoscopic cholecystectomy: A randomized double-blind placebo-controlled trial. Ann Surg, 2003; 238:651–660
European Society for Regional Anesthesia and Pain Theraphy. On line tool. Prospect (procedure specific postoperative pain managment) http://www.postoppain.org
Murphy G, Szokol J, Greenberg S, Avram M. et.al Preoperative Dexamethasone Enhances Quality of Recovery after Laparoscopic Cholecystectomy. Anesthesiology, 2011; 114: 882–990
Carlisle J, Stevenson C. Drugs for preventing postoperative nausea and vomiting. Cochrane Database of Systematic Reviews, issue. 7, 20
The authors who publish in this journal accept the following conditions:
1. The authors retain the copyright and grant to the CAMbios MEDICAL-SCIENTIFIC JOURNAL HECAM the right of the first publication, with the work registered with the Creative Commons attribution license, which allows third parties to use the published material provided that they mention the authorship of the work and the first publication in this journal.
2. Authors can make other independent and additional contractual agreements for the non-exclusive distribution of the version of the article published in this journal (for example, include it in an institutional repository or publish it in a book) as long as it clearly indicates that the work was published. for the first time in the CAMbios MEDICAL-SCIENTIFIC JOURNAL HECAM.