The Effective Analgesic Dose of Dexamethasone After Laparoscopic Hysterectomy
| Autor: | Minna Tallgren, Jouni Ahonen, Ritva Jokela, Pia C. Marjakangas, Kari Korttila |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.drug_class Analgesic Anti-Inflammatory Agents Remifentanil Anesthesia General Hysterectomy Placebo Dexamethasone 03 medical and health sciences 0302 clinical medicine Double-Blind Method 030202 anesthesiology Humans Medicine Antiemetic 030212 general & internal medicine Infusions Intravenous Pain Measurement Pain Postoperative Dose-Response Relationship Drug business.industry Middle Aged Effective dose (pharmacology) 3. Good health Analgesics Opioid Anesthesiology and Pain Medicine Anesthesia Female Laparoscopy business Propofol Oxycodone medicine.drug |
| Zdroj: | Anesthesia & Analgesia. 109:607-615 |
| ISSN: | 0003-2999 |
| Popis: | BACKGROUND: Apart from being antiemetic, glucocorticoids have an analgesic property. The optimal dose of dexamethasone in the management of pain after surgery has not been established. In this placebo-controlled, dose-finding study, we evaluated the analgesic effect of three doses of dexamethasone after laparoscopic hysterectomy. METHODS: We randomized 129 women scheduled for laparoscopic hysterectomy to receive placebo, dexamethasone 5 mg (D5), 10 mg (D10), or 15 mg (D15) IV before the induction of anesthesia. The patients were anesthetized with propofol and remifentanil in a standardized manner. Until the first postoperative morning, postoperative pain was managed with IV oxycodone using patient-controlled analgesia. The visual analog scale scores for pain and side effects, and the amounts of the analgesics were recorded for 3 days after surgery. RESULTS: The total dose of oxycodone (0–24 h after surgery) was smaller in the D15 (0.34 mg/kg [0.11–0.87]) group than in the placebo group (0.55 mg/kg [0.19–1.13]) (P 0.003). The doses of oxycodone during Hours 0–2 after surgery were smaller in the D10 (0.17 mg/kg [0.03–0.36]) and D15 (0.17 mg/kg [0.03–0.35]) groups than in the placebo (0.26 mg/kg [0.10–0.48]) (P 0.001, D10 versus placebo; P 0.001, D15 versus placebo) group. During Hours 2–24 after surgery, however, the doses of oxycodone were equal in the placebo, D5, D10, and D15 groups (0.31 mg/kg [0.03–0.78], 0.22 mg/kg [0.03–0.92], 0.24 mg/kg [0.05–0.87], and 0.20 mg/kg [0–0.65], respectively). The visual analog scale scores for pain at rest, in motion, or at cough did not differ in the study groups. The incidence of dizziness was lower in the D15 group than in the placebo group (P 0.001), the D5 group (P 0.006), and the D10 group (P 0.030) during the first 24 h after surgery. During the later course of recovery, the incidence of dizziness did not differ among the four study groups. CONCLUSIONS: IV dexamethasone 15 mg before induction of anesthesia decreases the oxycodone consumption during the first 24 h after laparoscopic hysterectomy. During first 2 h after surgery, dexamethasone 10 mg reduces the oxycodone consumption as effectively as the 15 mg dose. (Anesth Analg 2009;109:607‐15) |
| Databáze: | OpenAIRE |
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