Author: Zhang, Hong-Wei M.D.
Anesthesiology. October 2025. doi:10.1097/ALN.0000000000005695
This multicenter, double-blind randomized clinical trial evaluated whether a single preoperative dose of intravenous methylprednisolone (120 mg) could improve postoperative quality of recovery (QoR) in patients undergoing minimally invasive esophagectomy. A total of 160 patients from Sichuan Provincial People’s Hospital (Chengdu, China) were randomized to receive either methylprednisolone or placebo 30 minutes before surgery.
The primary endpoint was quality of recovery on postoperative day 2, measured using the QoR-15 questionnaire. Secondary outcomes included inflammatory markers (C-reactive protein), opioid consumption, time to first ambulation, rescue analgesia, postoperative hospital stay, morbidity, and 30-day home recovery.
Results showed a significantly higher QoR-15 score in the methylprednisolone group on postoperative day 2 (113.9 ± 14.0 vs. 106.0 ± 15.8; mean difference 7.9, 95% CI 2.0–13.7; P=0.009). Inflammatory markers were lower, opioid use decreased, and early mobilization improved in the methylprednisolone group. No significant differences were observed in adverse events or overall complications, supporting the safety of this approach.
What you should know:
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A single preoperative dose of methylprednisolone improved early recovery after minimally invasive esophagectomy.
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Benefits included better QoR scores, reduced inflammation, and less opioid use.
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Patients mobilized earlier without increased complications.
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Findings support methylprednisolone as a safe adjunct for enhanced recovery after esophagectomy.
Thank you to Anesthesiology for allowing me to use and summarize this article.