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Randomized clinical trial of dexamethasone versus placebo in laparoscopic inguinal hernia repair.
MedLine Citation:
PMID:  22961516     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: The effect of dexamethasone on recovery and length of convalescence has not been evaluated in patients after laparoscopic groin hernia repair. It was hypothesized that preoperative intravenous dexamethasone would reduce postoperative pain.
METHODS: Men undergoing transabdominal preperitoneal (TAPP) inguinal hernia repair were randomized to receive either a single intravenous dose of 8 mg dexamethasone or placebo (saline) 30-60 min before operation in a randomized double-blind trial. Patients in the two groups received similar standardized anaesthesia and analgesic regimens. The primary outcome measure was pain during coughing on postoperative day 1. Secondary outcomes were postoperative discomfort, fatigue and length of convalescence. Pain scores, discomfort and fatigue were recorded before surgery and daily on postoperative days 0-3 in a standard manner using visual analogue, verbal rating and numerical rating scales. The use of analgesics and antiemetics on the day of operation was recorded. The duration of time away from work and leisure activities was registered.
RESULTS: The study enrolled 80 patients. No significant differences were found between the groups regarding postoperative pain, need for analgesia, discomfort, fatigue, nausea, vomiting or length of convalescence. Patients who received placebo used significantly more antiemetics in the postanaesthesia care unit (PACU) than patients in the dexamethasone group (P = 0·026).
CONCLUSION: A single preoperative dose of 8 mg dexamethasone before laparoscopic groin hernia repair had no clinical effect on early postoperative pain, discomfort or fatigue after TAPP inguinal hernia repair, but resulted in a significantly lower use of antiemetics in the PACU. Registration number: NCT01170780 (http://www.clinicaltrials.gov). Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Authors:
M A Tolver; P Strandfelt; E B Bryld; J Rosenberg; T Bisgaard
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The British journal of surgery     Volume:  99     ISSN:  1365-2168     ISO Abbreviation:  Br J Surg     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  1374-80     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Affiliation:
Department of Surgery, Køge Hospital, University of Copenhagen, Køge, Herlev, Denmark. mette.astrup@gmail.com.
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