The effect of single low-dose dexamethasone on blood glucose concentrations in the perioperative period: a randomized, placebo-controlled investigation in gynecologic surgical patients
| Autor: | Michael J. Avram, Jeffery S. Vender, Jayla Gray, Torin D. Shear, Steven Greenberg, Joseph W. Szokol, Elizabeth Landry, Glenn S. Murphy |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Blood Glucose medicine.medical_specialty MEDLINE Anesthesia General Placebo Dexamethasone law.invention Gynecologic Surgical Procedures Randomized controlled trial Double-Blind Method law Medicine Humans Perioperative Period Aged Analysis of Variance business.industry Low dose Perioperative Middle Aged Surgery Anesthesiology and Pain Medicine Anesthesia Hyperglycemia Anesthesia Recovery Period Postoperative Nausea and Vomiting Antiemetics Female business Surgical patients medicine.drug |
| Zdroj: | Anesthesia and analgesia. 118(6) |
| ISSN: | 1526-7598 |
| Popis: | The effect of single low-dose dexamethasone therapy on perioperative blood glucose concentrations has not been well characterized. In this investigation, we examined the effect of 2 commonly used doses of dexamethasone (4 and 8 mg at induction of anesthesia) on blood glucose concentrations during the first 24 hours after administration.Two hundred women patients were randomized to 1 of 6 groups: Early-control (saline); Early-4 mg (4 mg dexamethasone); Early-8 mg (8 mg dexamethasone); Late-control (saline); Late-4 mg (4 mg dexamethasone); and Late-8 mg (8 mg dexamethasone). Blood glucose concentrations were measured at baseline and 1, 2, 3, and 4 hours after administration in the early groups and at baseline and 8 and 24 hours after administration in the late groups. The incidence of hyperglycemic events (the number of patients with at least 1 blood glucose concentration180 mg/dL) was determined.Blood glucose concentrations increased significantly over time in all control and dexamethasone groups (from median baselines of 94 to 102 mg/dL to maximum medians ranging from 141 to 161.5 mg/dL, all P0.001). Blood glucose concentrations did not differ significantly between the groups receiving dexamethasone (either 4 or 8 mg) and those receiving saline at any measurement time. The incidence of hyperglycemic events did not differ in any of the early (21%-28%, P = 0.807) or late (13%-24%, P = 0.552) groups.Because blood glucose concentrations during the first 24 hours after administration of single low-dose dexamethasone did not differ from those observed after saline administrations, these results suggest clinicians need not avoid using dexamethasone for nausea and vomiting prophylaxis out of concerns related to hyperglycemia. |
| Databáze: | OpenAIRE |
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