The Effect of Dexamethasone on Side Effects After Coronary Revascularization Procedures
| Autor: | Johan Raeder, Kjell Saatvedt, Paul F. White, Terje Veel, Sven M. Almdahl, K. Nordstrand, Per Halvorsen |
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| Rok vydání: | 2003 |
| Předmět: |
Male
medicine.medical_specialty Nausea medicine.drug_class medicine.medical_treatment Dexamethasone law.invention Double-Blind Method Randomized controlled trial law Atrial Fibrillation Myocardial Revascularization medicine Humans Anesthesia Prospective Studies cardiovascular diseases Coronary Artery Bypass Elective surgery Aged Postoperative Care Chemotherapy business.industry Atrial fibrillation Middle Aged medicine.disease Surgery Treatment Outcome Anesthesiology and Pain Medicine Anesthesia Recovery Period Postoperative Nausea and Vomiting cardiovascular system Vomiting Antiemetics Corticosteroid Female medicine.symptom business medicine.drug |
| Zdroj: | Anesthesia & Analgesia. :1578-1583 |
| ISSN: | 0003-2999 |
| Popis: | Corticosteroids decrease side effects after noncardiac elective surgery. We designed this randomized, double-blinded, placebo-controlled study to test the hypothesis that standard doses of dexamethasone (4 mg x2) would reduce postoperative nausea, vomiting, and pain, decrease the incidence of atrial fibrillation (AF), and improve appetite after cardiac surgery, thereby facilitating the recovery process. A total of 300 patients undergoing coronary revascularization surgery were enrolled in this clinical study. The anesthetic management was standardized in all patients. Dexamethasone (4 mg/mL) or saline (1 mL) was administered after the induction of anesthesia and a second dose of the same study drug was given on the morning after surgery. The incidence of AF was determined by analyzing the first 72 h of continuously recorded electrocardiogram records after cardiac surgery. The patients were assessed at 24- and 48-h intervals after surgery, as well as at the time of hospital discharge, to determine the incidence and severity of postoperative side effects (e.g., nausea, vomiting, pain) and patient satisfaction scores. Dexamethasone significantly reduced the need for antiemetic rescue medication on the first postoperative day (30% versus 42%), and the incidences of nausea (15% versus 26%) and vomiting (5% versus 16%) on the second postoperative day (P0.05). In addition, dexamethasone significantly reduced the percentage of patients with a depressed appetite on the second postoperative day. However, the corticosteroid failed to decrease the incidence of AF (27% versus 32%) or the total dosage of opioid analgesic medication administered in the postoperative period. We conclude that dexamethasone (8 mg in divided doses) was beneficial in reducing emetic symptoms and improving appetite after cardiac surgery. However, this dose of the corticosteroid does not seem to have antiarrhythmic or analgesic-sparing properties.Dexamethasone (8 mg IV) was beneficial in reducing emetic symptoms and increasing appetite after cardiac surgery. However, this dose of the corticosteroid failed to decrease postoperative pain or the incidence of new-onset atrial fibrillation. |
| Databáze: | OpenAIRE |
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