Effects of preoperative dexamethasone on postoperative pain, nausea, vomiting and respiratory function in women undergoing conservative breast surgery for cancer: Results of a controlled clinical trial

• Published in: European journal of cancer care Vol. 27; no. 1; pp. e12686 - n/a
• Main Authors: Cortés‐Flores, A.O., Jiménez‐Tornero, J., Morgan‐Villela, G., Delgado‐Gómez, M., Zuloaga‐Fernández del Valle, C. J., García‐Rentería, J., Rendón‐Félix, J., Fuentes‐Orozco, C., Macías‐Amezcua, M.D., Ambriz‐González, G., Alvarez‐Villaseñor, A.S., Urias‐Valdez, D., Chavez‐Tostado, M., Contreras‐Hernández, G. I., González‐Ojeda, A.
• Format: Journal Article
• Language: English
• Published: England Hindawi Limited 01.01.2018
• Subjects: Adenocarcinoma - surgery; Adult; Aged; Analgesics; Analgesics, Opioid - therapeutic use; Antiemetics; Antiemetics - therapeutic use; Breast cancer; Breast Neoplasms - surgery; Breast surgery; Cancer; Cancer surgery; Clinical trials; Complications; Dexamethasone; Dexamethasone - therapeutic use; Double-Blind Method; Drugs; Evidence-based medicine; Female; Forced Expiratory Volume; Humans; mastectomy; Mastectomy, Segmental; Middle Aged; Morphine - therapeutic use; Nausea; Nursing; Ondansetron - therapeutic use; Pain; Pain Measurement; Pain, Postoperative - drug therapy; Pain, Postoperative - epidemiology; Patients; Peak Expiratory Flow Rate; Postoperative Nausea and Vomiting - drug therapy; Postoperative Nausea and Vomiting - epidemiology; postoperative pain; Postoperative period; Preoperative Care - methods; Respiration Disorders - epidemiology; Respiration Disorders - physiopathology; Respiratory function; respiratory function tests; Respiratory system; Spirometry; Steroids; Surgery; Vital Capacity; Vomiting; Womens health; dexamethasone; mastectomy; respiratory function tests; postoperative pain; nausea; vomiting
• ISSN: 0961-5423; 1365-2354
• DOI: 10.1111/ecc.12686

The objective was to evaluate whether preoperative administration of dexamethasone improved postoperative nausea and vomiting (PONV), pain and respiratory function tests in women undergoing conservative surgery for breast cancer. This was a controlled clinical trial conducted between June 2013 and October 2014. Eighty patients were evaluated. Patients received a preoperative dose of 8 mg of dexamethasone (n = 40) or placebo (n = 40). The data on PONV and pain intensity was obtained and forced spirometry tests were performed, 1 hr before and at 1, 6, 12 and 24 hr after surgery. Any use of additional analgesic/antiemetic drugs was recorded. Patients were followed until 30 days after surgery for any surgical or medical complications. The pain intensity was lower in the treatment group for all periods; PONV was lower at 6, 12 and 24 hr; Additional analgesics/antiemetics were required less frequently (all p < .05). Both groups exhibited a restrictive ventilatory pattern immediately after surgery, which was reversed in the following hours. However, spirometric values were higher in the dexamethasone group. There were no pulmonary or metabolic complications after surgery. Our conclusions were that dexamethasone significantly reduced the incidences of PONV, pain and improved respiratory parameters, and reduced the need for additional postoperative analgesic and antiemetic drugs.