Key result
Perioperative administration of dexamethasone significantly decreased postoperative nausea and vomiting (OR 0.19) compared to controls in patients undergoing surgery.
Why the study?
Perioperative prophylactic dexamethasone is commonly given to reduce postoperative nausea, vomiting, and pain, but its overall efficacy and adverse effects required systematic evaluation.
Does perioperative administration of dexamethasone reduce postoperative nausea and vomiting and improve oral food intake tolerance in individuals undergoing surgery?
Systematic Review (n=31,048)
Does perioperative administration of dexamethasone reduce postoperative nausea and vomiting and improve oral food intake tolerance in individuals undergoing surgery?
Odds Ratio: 0.19 (95% CI 0.06–0.55)
Perioperative dexamethasone effectively reduces postoperative nausea and vomiting and improves oral food intake tolerance, but may increase the risk of impaired wound healing and major postoperative complications.
Supports dexamethasone for PONV reduction and feeding tolerance; confirms benefits but leaves open safety signals for wound healing and complications.
Background Perioperative prophylactic dexamethasone is commonly administered to reduce postoperative nausea and vomiting (PONV) and pain after surgery. In this study, we aimed to systematically review the efficacy and adverse effects of perioperative dexamethasone administration. Methods We conducted a systematic search until January 2023 in scientific databases, including PubMed, Scopus, Embase, Web of Science, and Google Scholar. After assessing the methodological quality of relevant studies, we synthesized those focusing on PONV, oral food intake tolerance, impaired wound healing, major postoperative complications, and postoperative infections following the perioperative administration of dexamethasone. Results A total of 27 studies were included in this systematic review and meta-analysis. The dexamethasone group showed decreased PONV (OR = 0.19; 95% CI 0.06–0.55), increased oral food intake tolerance (OR = 7.38; 95% CI 1.07–51.11), increased risk of impaired wound healing (OR = .48; 95% CI 0.52–4.21), decreased probability of postoperative infection (OR = 0.61; 95% CI 0.51–0.72), and increased risk of major postoperative complications (OR = 1.27; 95% CI 0.68–2.39) compared to the controls. Conclusions The results of our pooled data analysis showed that dexamethasone was superior to the control in terms of PONV, oral food intake tolerance, and postoperative infections.
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Najafzadeh et al. (2023) conducted a systematic review in Postoperative nausea and vomiting (PONV) and pain after surgery (n=31,048). Perioperative dexamethasone vs. Placebo or other antiemetic agents was evaluated on Postoperative nausea and vomiting (PONV) (OR 0.19, 95% CI 0.06-0.55). Perioperative administration of dexamethasone significantly decreased postoperative nausea and vomiting (OR 0.19) compared to controls in patients undergoing surgery.
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