Dexamethasone and postoperative analgesia in minimally invasive thoracic surgery: a retrospective cohort study
Abstract Background Dexamethasone is commonly used for the prevention of postoperative nausea and vomiting (PONV), and recent reviews suggest a role for dexamethasone in postoperative analgesia. The aim of this study is to evaluate the efficacy of dexamethasone as an analgesic adjuvant in minimally...
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| Format: | Article |
| Language: | English |
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BMC
2021-12-01
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| Series: | Journal of Anesthesia, Analgesia and Critical Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s44158-021-00023-6 |
| _version_ | 1828096287225937920 |
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| author | Marzia Umari Giacomo Paluzzano Matteo Stella Valentina Carpanese Giovanna Gallas Caterina Peratoner Giulia Colussi Gaia Maria Baldo Edoardo Moro Umberto Lucangelo Giorgio Berlot |
| author_facet | Marzia Umari Giacomo Paluzzano Matteo Stella Valentina Carpanese Giovanna Gallas Caterina Peratoner Giulia Colussi Gaia Maria Baldo Edoardo Moro Umberto Lucangelo Giorgio Berlot |
| author_sort | Marzia Umari |
| collection | DOAJ |
| description | Abstract Background Dexamethasone is commonly used for the prevention of postoperative nausea and vomiting (PONV), and recent reviews suggest a role for dexamethasone in postoperative analgesia. The aim of this study is to evaluate the efficacy of dexamethasone as an analgesic adjuvant in minimally invasive thoracic surgery. Primary outcome was morphine consumption 24 h after surgery; secondary outcomes were pain control, measured as numeric rating scale (NRS), glycemic changes, PONV, and surgical wound infection. Results We performed a retrospective cohort study considering 70 patients who underwent elective lobectomy, segmentectomy, or wedge resection surgery with a mini-thoracotomy approach or video-assisted thoracoscopic surgery (VATS). All patients received the same locoregional techniques and short-acting opioids during surgery; 46 patients received dexamethasone at induction. There were no significant differences in morphine consumption at 24 h (p = 0.09) and in postoperative pain scores. Nevertheless, a higher frequency of rescue therapy (p = 0.01) and a tendency for a higher attempted-PCA pushes count were observed in patients who did not receive dexamethasone. No cases of surgical wound infections were detected, and the incidence of PONV was similar in the two groups. Postoperative glycemia was transiently higher in the dexamethasone group (p = 0.004), but the need of hypoglycemic therapy was not significantly different. Conclusions Preoperative administration of dexamethasone did not cause a significant reduction in morphine consumption, but appears to be safe and plays a role in a multimodal anesthesia approach for patients undergoing elective minimally invasive thoracic surgery. |
| first_indexed | 2024-04-11T07:28:04Z |
| format | Article |
| id | doaj.art-dc2bc882c0fe44228e6adadf3094e673 |
| institution | Directory Open Access Journal |
| issn | 2731-3786 |
| language | English |
| last_indexed | 2024-04-11T07:28:04Z |
| publishDate | 2021-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Anesthesia, Analgesia and Critical Care |
| spelling | doaj.art-dc2bc882c0fe44228e6adadf3094e6732022-12-22T04:37:01ZengBMCJournal of Anesthesia, Analgesia and Critical Care2731-37862021-12-01111610.1186/s44158-021-00023-6Dexamethasone and postoperative analgesia in minimally invasive thoracic surgery: a retrospective cohort studyMarzia Umari0Giacomo Paluzzano1Matteo Stella2Valentina Carpanese3Giovanna Gallas4Caterina Peratoner5Giulia Colussi6Gaia Maria Baldo7Edoardo Moro8Umberto Lucangelo9Giorgio Berlot10Department of Anesthesia and Intensive Care, Azienda Sanitaria Universitaria Giuliano-Isontina, Cattinara University HospitalDepartment of Anesthesia and Intensive Care, Azienda Sanitaria Universitaria Giuliano-Isontina, Cattinara University HospitalDepartment of Anesthesia and Intensive Care, Azienda Sanitaria Universitaria Giuliano-Isontina, Cattinara University HospitalDepartment of Anesthesia and Intensive Care, Azienda Sanitaria Universitaria Giuliano-Isontina, Cattinara University HospitalDepartment of Anesthesia and Intensive Care, Azienda Sanitaria Universitaria Giuliano-Isontina, Cattinara University HospitalDepartment of Anesthesia and Intensive Care, Azienda Sanitaria Universitaria Giuliano-Isontina, Cattinara University HospitalDepartment of Anesthesia and Intensive Care, Azienda Sanitaria Universitaria Giuliano-Isontina, Cattinara University HospitalDepartment of Anesthesia and Intensive Care, Azienda Sanitaria Universitaria Giuliano-Isontina, Cattinara University HospitalDepartment of Anesthesia and Intensive Care, Azienda Sanitaria Universitaria Giuliano-Isontina, Cattinara University HospitalDepartment of Anesthesia and Intensive Care, Azienda Sanitaria Universitaria Giuliano-Isontina, Cattinara University HospitalDepartment of Anesthesia and Intensive Care, Azienda Sanitaria Universitaria Giuliano-Isontina, Cattinara University HospitalAbstract Background Dexamethasone is commonly used for the prevention of postoperative nausea and vomiting (PONV), and recent reviews suggest a role for dexamethasone in postoperative analgesia. The aim of this study is to evaluate the efficacy of dexamethasone as an analgesic adjuvant in minimally invasive thoracic surgery. Primary outcome was morphine consumption 24 h after surgery; secondary outcomes were pain control, measured as numeric rating scale (NRS), glycemic changes, PONV, and surgical wound infection. Results We performed a retrospective cohort study considering 70 patients who underwent elective lobectomy, segmentectomy, or wedge resection surgery with a mini-thoracotomy approach or video-assisted thoracoscopic surgery (VATS). All patients received the same locoregional techniques and short-acting opioids during surgery; 46 patients received dexamethasone at induction. There were no significant differences in morphine consumption at 24 h (p = 0.09) and in postoperative pain scores. Nevertheless, a higher frequency of rescue therapy (p = 0.01) and a tendency for a higher attempted-PCA pushes count were observed in patients who did not receive dexamethasone. No cases of surgical wound infections were detected, and the incidence of PONV was similar in the two groups. Postoperative glycemia was transiently higher in the dexamethasone group (p = 0.004), but the need of hypoglycemic therapy was not significantly different. Conclusions Preoperative administration of dexamethasone did not cause a significant reduction in morphine consumption, but appears to be safe and plays a role in a multimodal anesthesia approach for patients undergoing elective minimally invasive thoracic surgery.https://doi.org/10.1186/s44158-021-00023-6DexamethasonePostoperative painMinimally invasive thoracic surgeryMultimodal analgesia |
| spellingShingle | Marzia Umari Giacomo Paluzzano Matteo Stella Valentina Carpanese Giovanna Gallas Caterina Peratoner Giulia Colussi Gaia Maria Baldo Edoardo Moro Umberto Lucangelo Giorgio Berlot Dexamethasone and postoperative analgesia in minimally invasive thoracic surgery: a retrospective cohort study Journal of Anesthesia, Analgesia and Critical Care Dexamethasone Postoperative pain Minimally invasive thoracic surgery Multimodal analgesia |
| title | Dexamethasone and postoperative analgesia in minimally invasive thoracic surgery: a retrospective cohort study |
| title_full | Dexamethasone and postoperative analgesia in minimally invasive thoracic surgery: a retrospective cohort study |
| title_fullStr | Dexamethasone and postoperative analgesia in minimally invasive thoracic surgery: a retrospective cohort study |
| title_full_unstemmed | Dexamethasone and postoperative analgesia in minimally invasive thoracic surgery: a retrospective cohort study |
| title_short | Dexamethasone and postoperative analgesia in minimally invasive thoracic surgery: a retrospective cohort study |
| title_sort | dexamethasone and postoperative analgesia in minimally invasive thoracic surgery a retrospective cohort study |
| topic | Dexamethasone Postoperative pain Minimally invasive thoracic surgery Multimodal analgesia |
| url | https://doi.org/10.1186/s44158-021-00023-6 |
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