Randomised controlled trial of the effect of oral premedication with dexamethasone on hyperglycaemic response to abdominal hysterectomy.
Eur J Anaesthesiol
; 28(3): 195-201, 2011 Mar.
Article
em En
| MEDLINE
| ID: mdl-21192268
ABSTRACT
BACKGROUND:
This study was performed to evaluate the metabolic effects of a single oral dose of 8 mg dexamethasone in women undergoing hysterectomy.METHODS:
Ninety non-diabetic women undergoing abdominal hysterectomy were randomised to receive 8 mg dexamethasone or placebo 2 h before surgery. Patients' perioperative care was standardised (fasting from midnight before surgery, balanced anaesthesia using propofol, fentanyl, remifentanil, cisatracurium, desflurane in oxygen/air). At five defined time points after drug administration (approximately 2, 4, 6, 10 and 14 h), blood samples were drawn under fasting conditions to measure blood glucose and free (non-esterified) fatty acids (NEFA). Data were analysed using analysis of variance for repeated measures.RESULTS:
Data of 82 patients (dexamethasone 44 and placebo 38) were eligible for analysis. There was a statistically significant increase in blood glucose in both groups (P = 0.008). This increase was more pronounced in patients receiving dexamethasone (interaction term P = 0.02) with maximum values at 6 h after surgery (or approximately 10 h after dexamethasone administration). There were 36 patients (placebo 9 = 24% and dexamethasone 27 = 61%) presenting with elevated glucose concentrations (>7 mmol l⻹) and 11 patients (placebo 2 = 5% and dexamethasone 9 = 20%) with hyperglycaemia (>8.5 mmol l⻹). There were no statistically significant changes in the plasma concentrations of NEFA during the perioperative period.CONCLUSION:
Amounts of dexamethasone frequently used for prophylaxis of post-operative nausea and vomiting can cause short-lasting hyperglycaemia in the post-operative period, but no relevant alterations in fat metabolism. Thus, the benefits of administering corticosteroids should be weighed against the potential side-effects of short-lasting hyperglycaemia.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Dexametasona
/
Glucocorticoides
/
Hiperglicemia
/
Antieméticos
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
Limite:
Adult
/
Female
/
Humans
/
Middle aged
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article