Perioperative Dexamethasone
CA-1 · II.D.1.a.3.b.4 I.B.7.d.2 I.B.3.c.8
30Sources
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6 points
For analgesia rather than antiemesis the dose matters: doses above 0.1 mg/kg reduced pain and opioid consumption, low doses did not, and preoperative administration gave a more consistent effect than intraoperative.
PMID 21799397
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High-dose dexamethasone at 1 mg/kg in cardiac surgery did not reduce 30-day major adverse events (7.0% versus 8.5%); it lowered infection and ventilation time but raised postoperative glucose.
PMID 23117776
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In 2,628 breast cancer operations, a single perioperative dexamethasone dose was not associated with increased recurrence or mortality on propensity-matched analysis.
PMID 30894164
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Pooled across 60 trials, 4-5 mg of dexamethasone reduced 24-hour nausea and vomiting as effectively as 8-10 mg, supporting the lower SAMBA-recommended dose.
PMID 23223115
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In PADDI, 8 mg of dexamethasone was noninferior to placebo for surgical-site infection at 30 days (8.1% versus 9.1%), including in patients with diabetes, while cutting nausea and vomiting from 53.9% to 42.2%.
PMID 33951362
kept
Among 30,561 oncologic resections, dexamethasone was associated with lower 1-year mortality and better recurrence-free survival, while doses above 0.09 mg/kg raised hyperglycaemia without raising surgical-site infection.
PMID 35837889
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