Preoperative High Dose of Methylprednisolone Improves Early Postoperative Pulmonary Function, in Super-Obese Patients Undergoing Open Surgery; a Prospective, Comparative Study
| Autor: | George Skroubis, Petros Constantinopoulos, Fotis Kalfarentzos, George Theofanis, Charalampos Spyropoulos, Theodore K. Alexandrides, Anastasia Zotou |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Spirometry medicine.medical_specialty Vomiting Nausea medicine.medical_treatment Anti-Inflammatory Agents Placebo Methylprednisolone Pulmonary function testing 03 medical and health sciences Postoperative Complications 0302 clinical medicine Laparotomy medicine Humans Postoperative Period Prospective Studies Lung Pain Postoperative medicine.diagnostic_test Interleukin-6 business.industry Open surgery Gastroenterology Middle Aged Systemic Inflammatory Response Syndrome Obesity Morbid Surgery C-Reactive Protein 030220 oncology & carcinogenesis Anesthesia Female 030211 gastroenterology & hepatology medicine.symptom business medicine.drug |
| Zdroj: | Journal of Gastrointestinal Surgery. 20:1959-1965 |
| ISSN: | 1873-4626 1091-255X |
| DOI: | 10.1007/s11605-016-3281-1 |
| Popis: | Surgery stimulates an intense systemic inflammatory response which might increase postoperative morbidity. Corticosteroids may reduce this inflammatory reaction. The purpose of this study was to investigate any possible effect on postoperative morbidity and recovery after administrating methylprednisolone in super-obese patients undergoing open surgery. Sixty super-obese patients with BMI ≥50 kg/m2 (mean 57.48 ± 7.33), mean age of 39 ± 9 years, who underwent an open bariatric procedure, were enrolled. Thirty patients (group A) were allocated to a preoperative single dose of 30 mg/kg (ideal body weight) methylprednisolone versus placebo (group B, 30 patients). Endpoints included assessment of IL-6 and CRP; evaluation of postoperative pulmonary function, pain management, nausea, and vomiting; and documentation of postoperative complications. Significant improvement in spirometry parameters and arterial blood gas analysis, in the first and third postoperative days, was observed in the methylprednisolone group. IL-6 and CRP levels were significantly lower in that group. Administration of methylprednisolone was associated with less postoperative pain, nausea, and vomiting, with no statistical difference in septic complications. Preoperative administration of a single high dose of methylprednisolone in super-obese patients undergoing open surgery inhibits the inflammatory signaling cascade, lessens the systemic inflammatory response, and results in fewer pulmonary complications and better patient recovery. |
| Databáze: | OpenAIRE |
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