Intraoperative dexamethasone for antiemesis does not appear to significantly alter glucostasis during the first 24 post-operative hours in non-diabetic patients.

pearl

• Glenn S Murphy, Joseph W Szokol, Michael J Avram, Steven B Greenberg, Torin Shear, Jeffery S Vender, Jayla Gray, and Elizabeth Landry.
• From the *Department of Anesthesiology, NorthShore University HealthSystem, Evanston; and †Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
• Anesth. Analg.. 2014 Jun 1;118(6):1204-12.

BackgroundThe effect of single low-dose dexamethasone therapy on perioperative blood glucose concentrations has not been well characterized. In this investigation, we examined the effect of 2 commonly used doses of dexamethasone (4 and 8 mg at induction of anesthesia) on blood glucose concentrations during the first 24 hours after administration.MethodsTwo hundred women patients were randomized to 1 of 6 groups: Early-control (saline); Early-4 mg (4 mg dexamethasone); Early-8 mg (8 mg dexamethasone); Late-control (saline); Late-4 mg (4 mg dexamethasone); and Late-8 mg (8 mg dexamethasone). Blood glucose concentrations were measured at baseline and 1, 2, 3, and 4 hours after administration in the early groups and at baseline and 8 and 24 hours after administration in the late groups. The incidence of hyperglycemic events (the number of patients with at least 1 blood glucose concentration >180 mg/dL) was determined.ResultsBlood glucose concentrations increased significantly over time in all control and dexamethasone groups (from median baselines of 94 to 102 mg/dL to maximum medians ranging from 141 to 161.5 mg/dL, all P < 0.001). Blood glucose concentrations did not differ significantly between the groups receiving dexamethasone (either 4 or 8 mg) and those receiving saline at any measurement time. The incidence of hyperglycemic events did not differ in any of the early (21%-28%, P = 0.807) or late (13%-24%, P = 0.552) groups.ConclusionsBecause blood glucose concentrations during the first 24 hours after administration of single low-dose dexamethasone did not differ from those observed after saline administrations, these results suggest clinicians need not avoid using dexamethasone for nausea and vomiting prophylaxis out of concerns related to hyperglycemia.

33 keywords...

hide…