What question did this study set out to answer?

This trial aimed to evaluate the impact of dexamethasone on C-reactive protein levels and postoperative complications after robotic hysterectomy.

June 5, 2026Open Access

The effect of dexamethasone on inflammatory markers of surgical stress: a randomized trial in robotic hysterectomy

Key Points

This trial aimed to evaluate the impact of dexamethasone on C-reactive protein levels and postoperative complications after robotic hysterectomy.
Randomized trial comparing 24 mg dexamethasone with placebo in women undergoing robotic-assisted hysterectomy.
Blood tests for C-reactive protein and pain scores assessed at multiple time points postoperatively.
Adjustments made for BMI, age, and baseline CRP in data analysis.
Postoperative CRP levels were significantly lower in the dexamethasone group at 12 and 24 h, p < 0.001.
Postoperative nausea and vomiting were reduced, with p = 0.039 without adjustment and p = 0.02 with adjustment.
Overall, dexamethasone demonstrated a substantial reduction in surgical stress as indicated by lower CRP levels.

Abstract

The immunosuppressive action of dexamethasone may help reduce the risk of postoperative complications such as infection, adhesion formation, and delayed wound healing. Dexamethasone may mitigate tissue damage and hasten recovery by attenuating the inflammatory response, modulating immune cell activity, and reducing the release of pro-inflammatory cytokines. In this first randomized trial of dexamethasone in robotic hysterectomy, we aimed to evaluate its effect on reducing C-reactive protein (CRP) as a proxy marker of surgical stress. Women scheduled for robotic-assisted hysterectomy were recruited into a randomized trial comparing a preoperative dose of 24 mg dexamethasone with placebo. Blood tests were obtained, and visual analogue scale scores for pain, postoperative nausea and vomiting, and medication use during admission were recorded at 0, 4, 8, 12, and 24 h postoperatively. Among the 112 included women, postoperative CRP levels were lower in the dexamethasone group at 12 and 24 h. Postoperative nausea and vomiting over time were also reduced in the dexamethasone group ( p = 0.039 without adjustment; p = 0.02 with adjustment). Changes in CRP were analyzed using repeated-measures analysis, showing highly significant differences both without and with adjustment for BMI, age, and baseline CRP (both p < 0.001). Overall, the dexamethasone group demonstrated substantially lower CRP levels during the postoperative period. Dexamethasone significantly reduced postoperative CRP levels, suggesting a potential role in further reducing surgical stress in robotic-assisted hysterectomy. European medical agency (EUDRACT no.2021-000874-28). 02.06.2021. CTIS Public Portal (European Medicines Agency) Registry of randomized clinical trials: NCT 04762381, “Effect of 24mg Dexamethasone Preoperatively on Surgical Stress, Pain and Recovery in Robotic-assisted Laparoscopic Hysterectomy”, 11th March 2022. ClinicalTrials.gov

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