Dexamethasone improves quality of life after laparoscopic gallbladder surgery
A study presented at the American Society of Anesthesiologists 2010 Annual Meeting in San Diego seems to confirm that a single, small dose of the steroid dexamethasone improves the post-surgical quality of life of patients receiving laparoscopic gallbladder surgery.
"Our findings suggest that recovery after anesthesia can be significantly enhanced in this patient population by the administration of a small dose of steroid," said study author Glenn S. Murphy, M.D., University of Chicago Pritzker School of Medicine. "Many of the unpleasant symptoms that prevent a return to normal activities during the first few days after surgery can be reduced with a single dose of dexamethasone in the O.R."
Laparoscopic cholecystectomy (minimally invasive removal of the gall bladder) is one of the most common procedures performed in the western world, and the majority of patients are discharged home on the day of surgery.
Dr. Murphy said, however, that a variety of unpleasant responses can be activated in the body during the procedure, including nausea, vomiting, anorexia, fatigue, drowsiness and dizziness. Anesthesiologists continue to seek ways to reduce these complications while patients recover at home.
"The patients in our study who received dexamethasone in the O.R. reported an enhanced emotional state, improved physical comfort and reductions in postoperative pain during their first 24 hours at home," said Dr. Murphy.
Dexamethasone is being used with increasing frequency by anesthesiologists to specifically target post-surgical nausea and vomiting, but it may also produce beneficial effects such as improved appetite, reduced pain and improved mood and energy.
In the current study, Dr. Murphy and his research team enrolled 120 patients who received either a small dose of dexamethasone or placebo and were assessed for nausea, vomiting, pain, need for pain medication and fatigue within 24 hours after surgery.
Patients completed a 40-question survey designed specifically to assess how well patients recover from surgery, including questions about physical comfort, emotional state, physical independence, psychological support, and pain.
"On the first day following discharge from the hospital, global quality of recovery scores were significantly improved in patients administered dexamethasone compared to those given placebo," said Dr. Murphy. "They reported an enhanced emotional state, improved physical comfort and reductions in pain. Finally, total hospital length of stay was reduced by around 70 minutes in the dexamethasone group."
From AANA Essentials 10/20/2010
SOURCE American Society of Anesthesiologists