Dose ranging study on the effect of preoperative dexamethasone on postoperative quality of recovery and opioid consumption after ambulatory gynaecological surgery
Glucocorticoids are commonly administered before ambulatory surgery, although their effects on quality of recovery are not well characterized. The purpose of this study was to evaluate the dose-dependent effects of dexamethasone on patient recovery using the Quality of Recovery 40 questionnaire (QoR...
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| Published in | British journal of anaesthesia : BJA Vol. 107; no. 3; pp. 362 - 371 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Oxford
Elsevier Ltd
01.09.2011
Oxford University Press |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0007-0912 1471-6771 1471-6771 |
| DOI | 10.1093/bja/aer156 |
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| Abstract | Glucocorticoids are commonly administered before ambulatory surgery, although their effects on quality of recovery are not well characterized. The purpose of this study was to evaluate the dose-dependent effects of dexamethasone on patient recovery using the Quality of Recovery 40 questionnaire (QoR-40) after ambulatory surgery.
This prospective, double-blind trial studied 106 female subjects undergoing outpatient gynaecological laparoscopy. Subjects were randomized to receive saline, dexamethasone 0.05 mg kg−1 or dexamethasone 0.1 mg kg−1 before induction. The primary outcome was global QoR-40 at 24 h. Postoperative pain, analgesic consumption, side-effects, and discharge time were also evaluated.
Global median (IQR) QoR-40 after dexamethasone 0.1 mg kg−1 193 (192–195) was greater than dexamethasone 0.05 mg kg−1 179 (175–185) (P=0.004) or saline, 171 (160–182) (P<0.005). Median (IQR) morphine equivalents administered before discharge were 2.7 (0–6.3) mg after dexamethasone 0.1 mg kg−1 compared with 5.3 (2.4–8.8) mg and 5.3 (2.7–7.8) mg after dexamethasone 0.05 mg kg−1 and saline (P=0.02). Time to meet discharge criteria was 30 min shorter after dexamethasone 0.1 mg kg−1 compared with saline (P=0.005). At 24 h, subjects receiving dexamethasone 0.1 mg kg−1 had consumed less opioid analgesics, reported less sore throat, muscle pain, confusion, difficulty in falling asleep, and nausea compared with dexamethasone 0.05 mg kg−1 and saline.
Dexamethasone demonstrated dose-dependent effects on quality of recovery. Dexamethasone 0.1 mg kg−1 reduced opioid consumption compared with dexamethasone 0.05 mg kg−1, which may be beneficial for improving recovery after ambulatory gynaecological surgery. |
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| AbstractList | Glucocorticoids are commonly administered before ambulatory surgery, although their effects on quality of recovery are not well characterized. The purpose of this study was to evaluate the dose-dependent effects of dexamethasone on patient recovery using the Quality of Recovery 40 questionnaire (QoR-40) after ambulatory surgery.
This prospective, double-blind trial studied 106 female subjects undergoing outpatient gynaecological laparoscopy. Subjects were randomized to receive saline, dexamethasone 0.05 mg kg−1 or dexamethasone 0.1 mg kg−1 before induction. The primary outcome was global QoR-40 at 24 h. Postoperative pain, analgesic consumption, side-effects, and discharge time were also evaluated.
Global median (IQR) QoR-40 after dexamethasone 0.1 mg kg−1 193 (192–195) was greater than dexamethasone 0.05 mg kg−1 179 (175–185) (P=0.004) or saline, 171 (160–182) (P<0.005). Median (IQR) morphine equivalents administered before discharge were 2.7 (0–6.3) mg after dexamethasone 0.1 mg kg−1 compared with 5.3 (2.4–8.8) mg and 5.3 (2.7–7.8) mg after dexamethasone 0.05 mg kg−1 and saline (P=0.02). Time to meet discharge criteria was 30 min shorter after dexamethasone 0.1 mg kg−1 compared with saline (P=0.005). At 24 h, subjects receiving dexamethasone 0.1 mg kg−1 had consumed less opioid analgesics, reported less sore throat, muscle pain, confusion, difficulty in falling asleep, and nausea compared with dexamethasone 0.05 mg kg−1 and saline.
Dexamethasone demonstrated dose-dependent effects on quality of recovery. Dexamethasone 0.1 mg kg−1 reduced opioid consumption compared with dexamethasone 0.05 mg kg−1, which may be beneficial for improving recovery after ambulatory gynaecological surgery. Glucocorticoids are commonly administered before ambulatory surgery, although their effects on quality of recovery are not well characterized. The purpose of this study was to evaluate the dose-dependent effects of dexamethasone on patient recovery using the Quality of Recovery 40 questionnaire (QoR-40) after ambulatory surgery.BACKGROUNDGlucocorticoids are commonly administered before ambulatory surgery, although their effects on quality of recovery are not well characterized. The purpose of this study was to evaluate the dose-dependent effects of dexamethasone on patient recovery using the Quality of Recovery 40 questionnaire (QoR-40) after ambulatory surgery.This prospective, double-blind trial studied 106 female subjects undergoing outpatient gynaecological laparoscopy. Subjects were randomized to receive saline, dexamethasone 0.05 mg kg(-1) or dexamethasone 0.1 mg kg(-1) before induction. The primary outcome was global QoR-40 at 24 h. Postoperative pain, analgesic consumption, side-effects, and discharge time were also evaluated.METHODSThis prospective, double-blind trial studied 106 female subjects undergoing outpatient gynaecological laparoscopy. Subjects were randomized to receive saline, dexamethasone 0.05 mg kg(-1) or dexamethasone 0.1 mg kg(-1) before induction. The primary outcome was global QoR-40 at 24 h. Postoperative pain, analgesic consumption, side-effects, and discharge time were also evaluated.Global median (IQR) QoR-40 after dexamethasone 0.1 mg kg(-1) 193 (192-195) was greater than dexamethasone 0.05 mg kg(-1) 179 (175-185) (P=0.004) or saline, 171 (160-182) (P<0.005). Median (IQR) morphine equivalents administered before discharge were 2.7 (0-6.3) mg after dexamethasone 0.1 mg kg(-1) compared with 5.3 (2.4-8.8) mg and 5.3 (2.7-7.8) mg after dexamethasone 0.05 mg kg(-1) and saline (P=0.02). Time to meet discharge criteria was 30 min shorter after dexamethasone 0.1 mg kg(-1) compared with saline (P=0.005). At 24 h, subjects receiving dexamethasone 0.1 mg kg(-1) had consumed less opioid analgesics, reported less sore throat, muscle pain, confusion, difficulty in falling asleep, and nausea compared with dexamethasone 0.05 mg kg(-1) and saline.RESULTSGlobal median (IQR) QoR-40 after dexamethasone 0.1 mg kg(-1) 193 (192-195) was greater than dexamethasone 0.05 mg kg(-1) 179 (175-185) (P=0.004) or saline, 171 (160-182) (P<0.005). Median (IQR) morphine equivalents administered before discharge were 2.7 (0-6.3) mg after dexamethasone 0.1 mg kg(-1) compared with 5.3 (2.4-8.8) mg and 5.3 (2.7-7.8) mg after dexamethasone 0.05 mg kg(-1) and saline (P=0.02). Time to meet discharge criteria was 30 min shorter after dexamethasone 0.1 mg kg(-1) compared with saline (P=0.005). At 24 h, subjects receiving dexamethasone 0.1 mg kg(-1) had consumed less opioid analgesics, reported less sore throat, muscle pain, confusion, difficulty in falling asleep, and nausea compared with dexamethasone 0.05 mg kg(-1) and saline.Dexamethasone demonstrated dose-dependent effects on quality of recovery. Dexamethasone 0.1 mg kg(-1) reduced opioid consumption compared with dexamethasone 0.05 mg kg(-1), which may be beneficial for improving recovery after ambulatory gynaecological surgery.CONCLUSIONSDexamethasone demonstrated dose-dependent effects on quality of recovery. Dexamethasone 0.1 mg kg(-1) reduced opioid consumption compared with dexamethasone 0.05 mg kg(-1), which may be beneficial for improving recovery after ambulatory gynaecological surgery. Glucocorticoids are commonly administered before ambulatory surgery, although their effects on quality of recovery are not well characterized. The purpose of this study was to evaluate the dose-dependent effects of dexamethasone on patient recovery using the Quality of Recovery 40 questionnaire (QoR-40) after ambulatory surgery. This prospective, double-blind trial studied 106 female subjects undergoing outpatient gynaecological laparoscopy. Subjects were randomized to receive saline, dexamethasone 0.05 mg kg(-1) or dexamethasone 0.1 mg kg(-1) before induction. The primary outcome was global QoR-40 at 24 h. Postoperative pain, analgesic consumption, side-effects, and discharge time were also evaluated. Global median (IQR) QoR-40 after dexamethasone 0.1 mg kg(-1) 193 (192-195) was greater than dexamethasone 0.05 mg kg(-1) 179 (175-185) (P=0.004) or saline, 171 (160-182) (P<0.005). Median (IQR) morphine equivalents administered before discharge were 2.7 (0-6.3) mg after dexamethasone 0.1 mg kg(-1) compared with 5.3 (2.4-8.8) mg and 5.3 (2.7-7.8) mg after dexamethasone 0.05 mg kg(-1) and saline (P=0.02). Time to meet discharge criteria was 30 min shorter after dexamethasone 0.1 mg kg(-1) compared with saline (P=0.005). At 24 h, subjects receiving dexamethasone 0.1 mg kg(-1) had consumed less opioid analgesics, reported less sore throat, muscle pain, confusion, difficulty in falling asleep, and nausea compared with dexamethasone 0.05 mg kg(-1) and saline. Dexamethasone demonstrated dose-dependent effects on quality of recovery. Dexamethasone 0.1 mg kg(-1) reduced opioid consumption compared with dexamethasone 0.05 mg kg(-1), which may be beneficial for improving recovery after ambulatory gynaecological surgery. Background Glucocorticoids are commonly administered before ambulatory surgery, although their effects on quality of recovery are not well characterized. The purpose of this study was to evaluate the dose-dependent effects of dexamethasone on patient recovery using the Quality of Recovery 40 questionnaire (QoR-40) after ambulatory surgery. Methods This prospective, double-blind trial studied 106 female subjects undergoing outpatient gynaecological laparoscopy. Subjects were randomized to receive saline, dexamethasone 0.05 mg kg−1 or dexamethasone 0.1 mg kg−1 before induction. The primary outcome was global QoR-40 at 24 h. Postoperative pain, analgesic consumption, side-effects, and discharge time were also evaluated. Results Global median (IQR) QoR-40 after dexamethasone 0.1 mg kg−1 193 (192–195) was greater than dexamethasone 0.05 mg kg−1 179 (175–185) (P=0.004) or saline, 171 (160–182) (P<0.005). Median (IQR) morphine equivalents administered before discharge were 2.7 (0–6.3) mg after dexamethasone 0.1 mg kg−1 compared with 5.3 (2.4–8.8) mg and 5.3 (2.7–7.8) mg after dexamethasone 0.05 mg kg−1 and saline (P=0.02). Time to meet discharge criteria was 30 min shorter after dexamethasone 0.1 mg kg−1 compared with saline (P=0.005). At 24 h, subjects receiving dexamethasone 0.1 mg kg−1 had consumed less opioid analgesics, reported less sore throat, muscle pain, confusion, difficulty in falling asleep, and nausea compared with dexamethasone 0.05 mg kg−1 and saline. Conclusions Dexamethasone demonstrated dose-dependent effects on quality of recovery. Dexamethasone 0.1 mg kg−1 reduced opioid consumption compared with dexamethasone 0.05 mg kg−1, which may be beneficial for improving recovery after ambulatory gynaecological surgery. |
| Author | Marcus, R.J. McCarthy, R.J. Ahmad, S. Fitzgerald, P.C. De Oliveira, G.S. Altman, C.S. Panjwani, A.S. |
| Author_xml | – sequence: 1 givenname: G.S. surname: De Oliveira fullname: De Oliveira, G.S. – sequence: 2 givenname: S. surname: Ahmad fullname: Ahmad, S. – sequence: 3 givenname: P.C. surname: Fitzgerald fullname: Fitzgerald, P.C. – sequence: 4 givenname: R.J. surname: Marcus fullname: Marcus, R.J. – sequence: 5 givenname: C.S. surname: Altman fullname: Altman, C.S. – sequence: 6 givenname: A.S. surname: Panjwani fullname: Panjwani, A.S. – sequence: 7 givenname: R.J. surname: McCarthy fullname: McCarthy, R.J. email: r-mccarthy@northwestern.edu |
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| Snippet | Glucocorticoids are commonly administered before ambulatory surgery, although their effects on quality of recovery are not well characterized. The purpose of... Background Glucocorticoids are commonly administered before ambulatory surgery, although their effects on quality of recovery are not well characterized. The... |
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| SubjectTerms | Adult Ambulatory Surgical Procedures anaesthesia Analgesics, Opioid - administration & dosage Anesthesia Anesthesia Recovery Period Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Dexamethasone - administration & dosage Dose-Response Relationship, Drug Double-Blind Method Female general, gynaecological, recovery Gynecologic Surgical Procedures Humans Laparoscopy Medical sciences Middle Aged Pain, Postoperative - drug therapy Patient Discharge Prospective Studies recovery, postoperative, pain, postoperative, dexamethasone, postoperative nausea and vomiting Surveys and Questionnaires |
| Title | Dose ranging study on the effect of preoperative dexamethasone on postoperative quality of recovery and opioid consumption after ambulatory gynaecological surgery |
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