Dr Paul Karanicolas and colleagues determined the impact of prophylactic corticosteroid administration on postoperative nausea, vomiting, pain and complications in patients undergoing laparoscopic cholecystectomy.
The team searched 4 bibliographic databases, conference proceedings, reference lists of articles and textbooks, and contacted experts in the field of anesthesia and hepatobiliary surgery.
The team evaluated the methodologic quality of trials and extracted data regarding baseline characteristics, interventions, and outcomes.
|Dexamethasone seemed to reduce the severity of postoperative pain|
|Annals of Surgery |
The team pooled results from the studies using a random-effects model, evaluated the degree of heterogeneity, and explored potential explanations for heterogeneity.
The researchers identified 17 trials that met eligibility criteria and provided high quality evidence regarding steroid effectiveness.
Irrespective of other antiemetic medications, dexamethasone reduced the incidence of nausea, vomiting, and postoperative nausea or vomiting relative to placebo.
Dexamethasone also seemed to reduce the severity of postoperative pain, although substantial unexplained heterogeneity was present.
The research team noted that incidence of headache and dizziness was similar between groups.
Dr Karanicolas’s team commented, “Prophylactic dexamethasone decreases the incidence of nausea and vomiting after laparoscopic cholecystectomy relative to placebo and may decrease the severity of postoperative pain.”
“Dexamethasone does not increase the incidence of headaches or dizziness.”
“Surgeons should consider administering prophylactic corticosteroids to patients undergoing laparoscopic cholecystectomy, particularly those at high risk of postoperative nausea and vomiting.”