Effects of dexamethasone on quality of recovery following vaginal surgery: a randomized trial

Pauls, Rachel N.; Crisp, Catrina C.; Oakley, Susan H.; Westermann, Lauren B.; Mazloomdoost, Donna; Kleeman, Steven D.; Ghodsi, Vivian; Estanol, Maria Victoria

doi:10.1016/j.ajog.2015.05.061

Cited by 31 publications

(20 citation statements)

References 20 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…). After duplicates had been excluded, we identified 31 trials including 27 primary interventional RCTs and four follow‐up studies . Seventeen studies were included in the posterior repair group (14 first studies and 3 follow‐up studies) and 14 in the multicompartmental group (13 first studies and one follow‐up study).…”

Section: Resultsmentioning

confidence: 99%

A systematic review of reported outcomes and outcome measures in randomized trials evaluating surgical interventions for posterior vaginal prolapse to aid development of a core outcome set

Lourenço

Pergialiotis

Durnea

et al. 2020

Intl J Gynecology & Obste

View full text Add to dashboard Cite

Background: Recent systematic reviews have demonstrated wide variations on outcome measure selection and outcome reporting in trials on surgical treatments for anterior, apical and mesh prolapse surgery. A systematic review of reported outcomes and outcome measures in posterior compartment vaginal prolapse interventions is highly warranted in the process of developing core outcome sets. Objective: To evaluate outcome and outcome measures reporting in posterior prolapse surgical trials. Search strategy: We searched MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL). Selection criteria: Randomized trials evaluating the efficacy and safety of different surgical interventions for posterior compartment vaginal prolapse.Data collection and analysis: Two researchers independently assessed studies for inclusion, evaluated methodological quality, and extracted relevant data. Methodological quality, outcome reporting quality and publication characteristics were evaluated.

show abstract

Section: Resultsmentioning

confidence: 99%

A systematic review of reported outcomes and outcome measures in randomized trials evaluating surgical interventions for posterior vaginal prolapse to aid development of a core outcome set

Lourenço

Pergialiotis

Durnea

et al. 2020

Intl J Gynecology & Obste

View full text Add to dashboard Cite

show abstract

“…After crosschecking titles and abstracts, the full texts of 29 articles were examined in detail. Four randomized clinical trials [ 31 – 34 ] that included QoR-40 scores were eligible. However, we could only analyze three randomized clinical trials [ 32 – 34 ] (totaling 301 patients) because one study [ 31 ] did not report the absolute value of QoR-40 and we did not try to obtain their data.…”

Section: Resultsmentioning

confidence: 99%

“…Four randomized clinical trials [ 31 – 34 ] that included QoR-40 scores were eligible. However, we could only analyze three randomized clinical trials [ 32 – 34 ] (totaling 301 patients) because one study [ 31 ] did not report the absolute value of QoR-40 and we did not try to obtain their data. We were unable to include the other four randomized clinical trials [ 35 – 38 ] that were initially selected from the clinical trial registration sites because they were in progress and the results were not available at the time of our meta-analysis ( Fig 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Although the heterogeneity in our results was 0%, we applied the anticipated heterogeneity at 50% [ 30 ]. This is because the effect of dexamethasone observed in the trial [ 31 ], which we could not include in the meta-analysis, seemed to be lower than that in other trials included in the meta-analysis. If the 95% CI included a value of 0, we considered the difference statistically non-significant.…”

Section: Methodsmentioning

confidence: 92%

See 1 more Smart Citation

Effects of Steroids on Quality of Recovery and Adverse Events after General Anesthesia: Meta-Analysis and Trial Sequential Analysis of Randomized Clinical Trials

Mihara

Ishii

et al. 2016

PLoS ONE

View full text Add to dashboard Cite

BackgroundQuality of recovery (QoR) after surgery is a relevant outcome. The early postoperative quality of recovery of a patient can be determined using the QoR-40 questionnaire. The aim of this meta-analysis and Trial Sequential Analysis was to determine if perioperative administration of glucocorticosteroids improved patients’ quality of recovery after general anesthesia and if adverse events occurred.MethodsWe searched six databases, including trial registration sites. Randomized clinical trials reporting the efficacy of glucocorticosteroids on quality of recovery evaluated using the QoR-40 after general anesthesia were eligible. The QoR-40 data were combined as the mean difference with confidence intervals using a random-effects model. The I2 statistic was used to assess heterogeneity. The quality of the trials was evaluated using the Cochrane methodology. Moreover, Trial Sequential Analysis was carried out to prevent the inflation of type 1 errors caused by multiple testing and sparse data. We also assessed adverse events.ResultsThree randomized clinical trials (totaling 301 patients) were analyzed. The results from one published and four unpublished randomized clinical trials were unavailable. Dexamethasone was investigated in all three trials, and the results suggested that it significantly improved QoR-40 at postoperative day one scores compared with placebo (mean difference [95% confidence interval]: 14.2 points [10.4 to 18.1]; P < 0.001; I2 = 0%). We could not conduct sensitivity analysis because of the absence of trials with low risk of bias. The Trial Sequential Analysis-adjusted confidence interval was -1.6 to 30.0, indicating that further trials are required. The reporting of adverse events was insufficient.ConclusionsThese findings indicate that perioperative dexamethasone administration may improve short-term (i.e., one day) quality of recovery after general anesthesia and surgery. We need more randomized clinical trials with low risk of bias assessing the effects of glucocorticosteroids on quality of life, other outcomes, and adverse events. Updated systematic reviews should then be conducted.Trial RegistrationUniversity Hospital Medical Information Network Clinical Trials Registry: UMIN000015678.

show abstract

“…34 Use of dexamethasone prior to vaginal reconstructive surgery was associated with less nausea/ vomiting and need for antiemetics as well as greater success with voiding trials. Furthermore, quality of recovery was enhanced, suggesting use of dexamethasone should be considered for these patients as suggested by Pauls et al 35 Valentin et al, have revealed that dexamethasone can reduce the incidence of post-operative cognitive decline (POCD) in elderly patients undergoing surgery, especially when associated with BIS 46-55. The effect of dexamethasone on S100β might be related with some degree of neuroprotection.…”

Section: Quality Of Recoverymentioning

confidence: 98%

Role of Dexamethasone in Peri-operative Anesthesia Management: A Review of Literature

Gupta¹

2017

Anesthesiol Open J

View full text Add to dashboard Cite

Dexamethasone has been used widely in clinical specialties including anesthesia. It is regarded as one of the ideal peri-operative agent being readily available, cheap, anti-inflammatory agent, prevents and treats post-operative nausea and vomiting (PONV), promotes appetite, suppress inflammation, a good analgesic agent both as intravenously or as an adjuvant to peripheral nerve blocks, it provides a sense of well-being and is considered to have a good quality of recovery and early discharge in patients from anesthesia. Controversial role of dexamethasone in causing post-operative surgical site infections have been solved and overall adverse effects of dexamethasone are rare and its benefits out-weighs the risks involved. The author did a literature search in Google Scholar and PubMed databases (latest articles related to the role of dexamethasone in peri-operative period over a period of two years 2015-17).KEY WORDS: Dexamethasone; Peri-operative agent; Anesthesia. KEY MESSAGES:Dexamethasone has a tremendous role in preventing post-operative nausea and vomiting, it has a fair analgesic action if given intravenously, epidurally or perineurally, patients receiving dexamethasone have enhanced recovery profiles after surgery and single dose would usually not increase the risk of surgical site infections. Overall adverse effects of dexamethasone are rare and its benefits out-weighs the risks involved.

show abstract

Effects of dexamethasone on quality of recovery following vaginal surgery: a randomized trial

Cited by 31 publications

References 20 publications

A systematic review of reported outcomes and outcome measures in randomized trials evaluating surgical interventions for posterior vaginal prolapse to aid development of a core outcome set

A systematic review of reported outcomes and outcome measures in randomized trials evaluating surgical interventions for posterior vaginal prolapse to aid development of a core outcome set

Effects of Steroids on Quality of Recovery and Adverse Events after General Anesthesia: Meta-Analysis and Trial Sequential Analysis of Randomized Clinical Trials

Role of Dexamethasone in Peri-operative Anesthesia Management: A Review of Literature

Contact Info

Product

Resources

About