Authors: Kumar S et al
Cureus 18(10): e118603. doi:10.7759/cureus.118603
Background & aims
Glucocorticoids, known for their anti-inflammatory and immunomodulatory effects, have shown promise in reducing postoperative pain. We compared the effect of single-dose systemic preoperative dexamethasone (8 mg) with placebo-controlled patients on postoperative analgesia and blood sugar levels in patients undergoing percutaneous nephrolithotomy.
Material & methods
The placebo-controlled randomised, double blind study was carried out on 70 ASA grade I and II patients, aged 18-60 years, of either gender undergoing percutaneous nephrolithotomy under general anaesthesia.
Intravenous (IV) dexamethasone 8 mg/2 ml or normal saline 2 ml is given to patients preoperatively 1 hour before surgery. Patients’ haemodynamic data, baseline blood sugar levels, and Visual Analogue Scale (VAS) scores were recorded. Postoperatively, before shifting to the Post Anaesthesia Care Unit (PACU), blood sugar was tested. After shifting to the PACU, haemodynamic data, VAS scores, and the requirement for injection paracetamol were recorded at 0, 6, 12, 24 and 48 hrs.
Results
A two-way repeated-measures ANOVA with Greenhouse-Geisser correction showed a significant difference in VAS scores between the Dexamethasone and Normal Saline groups (p < 0.001), but no significant difference between the two groups in random blood glucose levels over time (p = 0.537).
Conclusion
Preoperative administration of a single dose intravenous dexamethasone in patients undergoing percutaneous nephrolithotomy significantly reduces the requirement for postoperative rescue analgesia and has no significant effect on blood sugar.