TY - JOUR
TI - A Narrative Review of the Evidence on the Efficacy of Dexamethasone on Postoperative Analgesic Consumption
AU - Batistaki, C.
AU - Kaminiotis, E.
AU - Papadimos, T.
AU - Kostopanagiotou, G.
JO - The Clinical Journal of Pain
PY - 2017
VL - 33
TODO - 11
SP - 1037-1046
PB - Lippincott Williams and Wilkins
SN - 0749-8047, 1536-5409
TODO - 10.1097/AJP.0000000000000486
TODO - analgesic agent;  dexamethasone;  placebo;  analgesic agent;  antiinflammatory agent;  dexamethasone, analgesic activity;  breast surgery;  drug efficacy;  evidence based practice;  general surgery;  gynecologic surgery;  head and neck surgery;  human;  laparoscopic cholecystectomy;  orchidopexy;  orthopedic surgery;  postoperative analgesia;  postoperative care;  postoperative pain;  priority journal;  prospective study;  randomized controlled trial (topic);  Review;  spine surgery;  systematic review;  thyroid surgery;  tonsillectomy;  combination drug therapy;  postoperative pain, Analgesics;  Anti-Inflammatory Agents;  Dexamethasone;  Drug Therapy, Combination;  Humans;  Pain, Postoperative
TODO - Objectives: The effect of dexamethasone on analgesic consumption has not been adequately studied. The aim of this review was to investigate recent literature regarding the possible effect of dexamethasone on postoperative analgesic consumption. Methods: Critical review of randomized trials and prospective consecutive studies investigating the postoperative analgesic effect of dexamethasone was performed. Only studies published during 2006 to 2015 were included. Results: Forty-one studies met the inclusion criteria; 33 in adults and 8 in children (9 in general surgery, 8 in gynecologic/breast surgery, 8 in orthopedic/spinal surgery, 8 in head/neck surgery, 7 in children's tonsillectomy, and 1 in children's orchiopexy). Literature review demonstrated that dexamethasone can decrease analgesic requirements in patients undergoing laparoscopic cholecystectomies, laparoscopic gynecologic and breast surgery; whereas there is no consensus regarding orthopedic procedures, with positive evidence mostly regarding spinal surgeries. The efficacy of dexamethasone during head and neck surgery is not conclusive; however, its use before thyroid surgery may be beneficial. In children a beneficial impact of dexamethasone administration was revealed on posttonsillectomy reduction of analgesic needs. Studies on other kinds of operations in children are lacking. Conclusions: Dexamethasone administered at a dose of 8mg before surgical incision may be beneficial in laparoscopic cholecystectomies, thyroid, laparoscopic gynecologic and breast surgery, and tonsillectomies in children. Dexamethasone's potential impact on reducing postoperative analgesic requirements should be investigated in more detail in a systematic manner, to support its use in other kinds of operations. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
ER -