Key result
Intraperitoneal dexamethasone reduces postoperative shoulder pain and cuts nausea and vomiting ~67% versus placebo.
Why the study?
The reduction of shoulder pain and postoperative nausea and vomiting after gynecological laparoscopy requires preventive or treatment strategies.
Does intraperitoneal dexamethasone reduce shoulder pain and postoperative nausea and vomiting in patients undergoing gynecological laparoscopy?
RCT (n=130)
Double-blind
Randomly assigned
No
Does intraperitoneal dexamethasone reduce shoulder pain and postoperative nausea and vomiting in patients undergoing gynecological laparoscopy?
p-value: p=0.001
Intraperitoneal dexamethasone significantly reduces shoulder pain, opioid requirement, and postoperative nausea and vomiting after gynecological laparoscopy.
May support IP dexamethasone for post-laparoscopy shoulder pain and PONV; hypothesis-generating and requires larger confirmatory trials.
Background: The reduction of shoulder pain and postoperative nausea and vomiting (PONV), causing great discomfort for patients after gynecological laparoscopy, requires preventive or treatment strategies. Objectives: The present study aimed to determine the efficacy of intraperitoneal (IP) dexamethasone in the reduction of shoulder pain and PONV after gynecological laparoscopy. Methods: In this double-blind, randomized clinical trial, 130 consecutive patients undergoing gynecological laparoscopy were randomly assigned to two groups of 65 patients within May 2015 to May 2016. One group received 16 mg IP dexamethasone before the end of the surgery, and the other group received the placebo (i.e., the IP infusion of distilled water). Patients' age and body mass index (BMI), and surgery duration were recorded in this study. The severity of shoulder pain was evaluated by the visual analog scale (VAS) at recovery and 2, 6, 12, and 24 h after the surgery. Moreover, the need for opioid use and PONV were recorded within the first 24 h after the surgery. The study outcomes were compared between the two study groups and among the different intervals using SPSS software (version 21). Results: The groups had similar demographics (i.e., age and BMI) and mean surgery duration (P > 0.05). The mean values of VAS scores of the intervention group were lower than those of the placebo group at five intervals (P = 0.001). The frequency of opioid use was significantly lower in the dexamethasone group (P = 0.010). In addition, 20% and 60% of the patients in the dexamethasone and placebo groups had PONV, respectively (P < 0.001). Conclusions: The IP dexamethasone is effective in the reduction of shoulder pain and nausea/vomiting after gynecological laparoscopy and can significantly reduce opioid requirement within the first 24 h after surgery; however, IP dexamethasone does not increase surgery duration. Therefore, it is recommended to use this technique during gynecological laparoscopy.
No takes yet. Share an insight, caveat, or question.
Arab et al. (2021) conducted an RCT in Postoperative shoulder pain and nausea/vomiting after gynecological laparoscopy (n=130). Intraperitoneal dexamethasone vs. Placebo (distilled water) was evaluated on Severity of shoulder pain evaluated by visual analog scale (VAS) at recovery and 2, 6, 12, and 24 hours post-surgery (p=0.001). Intraperitoneal infusion of 16 mg dexamethasone significantly reduced postoperative shoulder pain across all intervals (P=0.001) and decreased the incidence of nausea and vomiting from 60% to 20% (P<0.001) compared to placebo.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: