A Single Perioperative Injection of Dexamethasone Decreases Nausea, Vomiting, and Pain after Laparoscopic Donor Nephrectomy

Yamanaga, Shigeyoshi; Posselt, Andrew M.; Freise, Chris E.; Kobayashi, Takaaki; Tavakol, Mehdi; Kang, ⋅Sang-Mo

doi:10.1155/2017/3518103

Cited by 17 publications

(13 citation statements)

References 30 publications

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“…[27] In a previous study, Yamanaga et al reported an incidence of PONV higher than 60% in patients undergoing laparoscopic donor nephrectomy. [28] Therefore, an opioid-based PCA regimen with a lower risk of PONV is particularly important among high-risk laparoscopic surgery patients.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Sufentanil- and Fentanyl-based Intravenous Patient-controlled Analgesia on Postoperative Nausea and Vomiting after Laparoscopic Nephrectomy: A Prospective, Double-blind, Randomized-controlled Trial

et al. 2020

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Background:The incidence of postoperative nausea and vomiting (PONV) remains high. The effects of sufentanil for PONV is not firmly confirmed. The aim of this study was to compare the effect of sufentanil-and fentanyl-based intravenous patient-controlled analgesia (IV-PCA) on the incidence of PONV after laparoscopic nephrectomy. Methods: Eighty-six patients were randomly allocated to receive either the sufentanil (n =43) or fentanyl (n =43). IV-PCA was prepared using either sufentanil 3 µg/kg or fentanyl 20 µg/kg, ramosetron 0.3 mg, and ketorolac 120 mg. The primary outcome of was the incidence of PONV during 24 h after post anesthesia care unit (PACU) discharge. The secondary outcomes were the modified Rhodes index and patient satisfaction scores at 24 h after PACU discharge, need for rescue antiemetics, pain score, need for additional analgesics, and cumulative consumption of IV-PCA Results: The incidence of PONV was comparable between the sufentanil and fentanyl groups (64.3% vs. 65%, p = 0.946; respectively). The number of patients who required antiemetics (p = 0.946) and the modified Rhodes index at 24 h after post-anesthesia care unit discharge (p = 0.668) were also comparable in both groups. No significant differences were found in the secondary outcomes, including the analgesic profiles and adverse events between the groups. Conclusions: In conclusion, sufentanil-and fentanyl-based IV-PCA showed similar incidence of PONV with comparable analgesic effects after laparoscopic nephrectomy. Based on these results, we suggest that sufentanil and fentanyl may provide comparable effects for IV-PCA after laparoscopic nephrectomy.

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Section: Discussionmentioning

confidence: 99%

Comparison of Sufentanil- and Fentanyl-based Intravenous Patient-controlled Analgesia on Postoperative Nausea and Vomiting after Laparoscopic Nephrectomy: A Prospective, Double-blind, Randomized-controlled Trial

et al. 2020

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“…Another plausible mechanism for PONV prophylaxis by corticosteroids is opioid-sparing effects because the postoperative use of opioids has been identified as an independent predictor of PONV [ 8 , 21 , 22 ]. Perineural dexamethasone infiltration has been shown to reduce the incidence of PONV in association with a decrease in postoperative opioid consumption consistent with superior pain relief [ 14 – 16 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Relationship between dexamethasone added to periarticular anesthetic infiltration and postoperative nausea and vomiting following total knee arthroplasty under general anesthesia: a retrospective observational study

Yano¹,

Imaizumi²,

Matsu-ura³

et al. 2020

JA Clin Rep

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Background: Periarticular anesthetic infiltration (PAI) with a corticosteroid is a modality for pain control following total knee arthroplasty (TKA). Systemic corticosteroids are an established antiemetic for the prophylaxis of postoperative nausea and vomiting (PONV). The purpose of this retrospective observational study was to elucidate the relationship between dexamethasone added to PAI and PONV in patients who underwent TKA. Methods: Data from 435 patients who received PAI using ropivacaine with or without dexamethasone were reviewed. The primary outcome was the incidence of PONV within 24 h following TKA. The incidence of deep incisional and organ/space surgical site infection (SSI) within the first year was also assessed. Results: The overall incidence of PONV was 23.2%. A multivariate logistic regression analysis showed that dexamethasone added to PAI was independently associated with a reduced incidence of PONV (adjusted odds ratio, 0.23; 95% confidence interval, 0.12-0.44, P < 0.001). The incidence of PONV and rescue analgesic requirements within 24 h were lower in patients who received PAI with dexamethasone than in those who received PAI alone (19.5% vs 49.1%, P < 0.001, 7.9% vs 29.1%, P < 0.001, respectively). SSI developed in one out of the 55 patients who received PAI alone, but in none of those who received PAI with dexamethasone. Conclusions: Dexamethasone added to PAI for postoperative pain management was independently associated with a lower risk of PONV within 24 h of TKA.

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“…Dexamethasone has been used for many years to reduce the incidence of PONV (5)(6)(7)(8)21) . Currently, it is recommended as a single perioperative injection of 8-14 mg to decrease PONV in the rst 24 h after surgery (22) . It also has analgesic effects, improves respiratory parameters, decreases fatigue, low-cost drug and promotes better recovery (3,19,21,22) .…”

Section: Discussionmentioning

confidence: 99%

“…Currently, it is recommended as a single perioperative injection of 8-14 mg to decrease PONV in the rst 24 h after surgery (22) . It also has analgesic effects, improves respiratory parameters, decreases fatigue, low-cost drug and promotes better recovery (3,19,21,22) . However, PONV prophylaxis with dexamethasone (8 mg) IV increases postoperative blood glucose values in non-diabetic and diabetic patients, irrespective of baseline blood glucose levels (23) .…”

Section: Discussionmentioning

confidence: 99%

Effects of aprepitant /dexamethasone versus mirtazapine/dexamethasone on postoperative nausea and vomiting after laparoscopic sleeve gastrectomy: a randomized controlled trial

Ashoor¹,

Kassim²,

Hasseb³

et al. 2020

Preprint

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Background Co-administration of different antiemetics proved to decrease postoperative nausea and vomiting (PONV) following laparoscopic sleeve gastrectomy (LSG). The investigators compared the combination of aprepitant and dexamethasone (A/D) with the combination of mirtazapine and dexamethasone (M/D) for prevention of PONV in morbidly obese patients undergoing LSG. Methods Ninety patients scheduled for LSG were assigned to receive a single preoperative dose of dexamethasone 8 mg IVI (D group), and in addition to oral aprepitant 80 mg (A/D group) or oral mirtazapine 30 mg (M/D group) in a randomized, double-blind trial. Assessment of PONV was done 0–2 h (early) and 2–24 hours (late). Patients’ level of sedation, satisfaction and postoperative pain were also assessed. Results A/D and M/D groups were superior to D group for complete response 0–24 h after surgery (79.3% for A/D group, 78.6% for M/D group and 20.7% for D group). D group was inferior to A/D and M/D groups regarding collective PONV and use of rescue antiemetics (P < 0.001) 0–24 h after surgery. The peak nausea scores 2–24 h were significantly lower in both A/D and M/D groups vs. D group (P = 0.005). Patients in the M/D group showed higher sedation scores while those in A/D groups showed lower pain scores and less analgesic requirements. A/D and M/D groups were superior to D group regarding the patient’s satisfaction score. Conclusion A/D and M/D combinations were superior to D alone regarding the proportion of patients exhibiting a complete response in preventing PONV associated with LSG. Trial Registration: Clinical Trials. gov Identifier: NCT04013386/ prospectively registered: 09/07/2019, http://www.Clinical Trial.gov

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A Single Perioperative Injection of Dexamethasone Decreases Nausea, Vomiting, and Pain after Laparoscopic Donor Nephrectomy

Cited by 17 publications

References 30 publications

Comparison of Sufentanil- and Fentanyl-based Intravenous Patient-controlled Analgesia on Postoperative Nausea and Vomiting after Laparoscopic Nephrectomy: A Prospective, Double-blind, Randomized-controlled Trial

Comparison of Sufentanil- and Fentanyl-based Intravenous Patient-controlled Analgesia on Postoperative Nausea and Vomiting after Laparoscopic Nephrectomy: A Prospective, Double-blind, Randomized-controlled Trial

Relationship between dexamethasone added to periarticular anesthetic infiltration and postoperative nausea and vomiting following total knee arthroplasty under general anesthesia: a retrospective observational study

Effects of aprepitant /dexamethasone versus mirtazapine/dexamethasone on postoperative nausea and vomiting after laparoscopic sleeve gastrectomy: a randomized controlled trial

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