Abstract
Background
Dexamethasone has analgesic properties when given intravenously before surgery, but the optimal dose has not been determined. We hypothesised that a dose of 40 mg dexamethasone would improve analgesia after outpatient shoulder surgery compared with 8 mg.
Methods
A randomised, double-blind, placebo-controlled clinical trial was conducted at Horsens Regional Hospital, Denmark. Patients scheduled for arthroscopic subacromial decompression and/or acromioclavicular joint resection as an outpatient procedure (n = 101) were randomised to receive intravenous dexamethasone 40 mg (D40), 8 mg (D8) or placebo (D0) before surgery. The primary outcome was pain intensity 8 h after surgery rated on a numeric rating scale of 0 to 10. Secondary outcomes were pain intensity, analgesic consumption and side effects during the first 3 days after surgery.
Results
Data from 73 patients were available for analysis: (D40: 25, D8: 26, D0: 22 patients). Eight hours after surgery, pain intensity were: [median (interquartile range)] group D40: 2 (1–4), group D8: 2.5 (1–5), group D0: 4 (2–7). There was no significant difference in pain intensity between group D40 and D8 after 8 h (P = 0.46) or at any other time. When comparing all three groups, a statistically significant dose–response relationship was seen for present, average and worst pain intensity after 8 h and on the following morning. No differences were found in analgesic consumption. No serious side effects were observed.
Conclusion
Although our data supported a dose–response relationship, increasing the dexamethasone dose from 8 to 40 mg did not improve analgesia significantly after outpatient shoulder surgery.
Dexamethasone has analgesic properties when given intravenously before surgery, but the optimal dose has not been determined. We hypothesised that a dose of 40 mg dexamethasone would improve analgesia after outpatient shoulder surgery compared with 8 mg.
Methods
A randomised, double-blind, placebo-controlled clinical trial was conducted at Horsens Regional Hospital, Denmark. Patients scheduled for arthroscopic subacromial decompression and/or acromioclavicular joint resection as an outpatient procedure (n = 101) were randomised to receive intravenous dexamethasone 40 mg (D40), 8 mg (D8) or placebo (D0) before surgery. The primary outcome was pain intensity 8 h after surgery rated on a numeric rating scale of 0 to 10. Secondary outcomes were pain intensity, analgesic consumption and side effects during the first 3 days after surgery.
Results
Data from 73 patients were available for analysis: (D40: 25, D8: 26, D0: 22 patients). Eight hours after surgery, pain intensity were: [median (interquartile range)] group D40: 2 (1–4), group D8: 2.5 (1–5), group D0: 4 (2–7). There was no significant difference in pain intensity between group D40 and D8 after 8 h (P = 0.46) or at any other time. When comparing all three groups, a statistically significant dose–response relationship was seen for present, average and worst pain intensity after 8 h and on the following morning. No differences were found in analgesic consumption. No serious side effects were observed.
Conclusion
Although our data supported a dose–response relationship, increasing the dexamethasone dose from 8 to 40 mg did not improve analgesia significantly after outpatient shoulder surgery.
| Original language | English |
|---|---|
| Journal | Acta Anaesthesiologica Scandinavica |
| Volume | 58 |
| Issue | 6 |
| Pages (from-to) | 751-758 |
| Number of pages | 8 |
| ISSN | 0001-5172 |
| DOIs | |
| Publication status | Published - 2014 |