Key result
Perioperative administration of dexamethasone reduces postoperative pain and opioid consumption, improves patient-reported recovery, and reduces length of stay, but shows no clear benefit for preventing postoperative delirium or cognitive dysfunction.
Why the study?
New evidence has emerged regarding perioperative dexamethasone beyond antiemetic prophylaxis, including analgesia, cognitive protection, recovery quality, and complication prevention in cardiac surgery.
Does perioperative dexamethasone improve pain, quality of recovery, and reduce complications in adult surgical patients?
Does perioperative dexamethasone improve pain, quality of recovery, and reduce complications in adult surgical patients?
Perioperative dexamethasone provides modest analgesic and opioid-sparing effects and improves quality of recovery, but its role in preventing postoperative cognitive dysfunction, delirium, or major complications in cardiac surgery remains inconclusive.
May support expanded perioperative dexamethasone use; leaves open confirmation by RCTs before changing practice.
Dexamethasone is already routinely used as antiemetic prophylaxis for postoperativenausea and vomiting (PONV). Some evidence has been gathered in the past years forperioperative administration of dexamethasone in other indications: analgesic effects, prevention against postoperative cognitive decline or delirium, quality of recovery, prevention of complications in cardiac surgery... We performed a review of the literature to synthesize the new evidence about dexamethasone.
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Smolders et al. (2022) conducted a review in Surgery. Dexamethasone vs. Placebo or standard care was evaluated. Perioperative administration of dexamethasone reduces postoperative pain and opioid consumption, improves patient-reported recovery, and reduces length of stay, but shows no clear benefit for preventing postoperative delirium or cognitive dysfunction.
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