Evaluation of quality of recovery score in mothers and neonatal outcome assessment after surgery using preoperative dexamethasone for caesarean section

Patnaik, Subhasish; Singh, Shalendra; Vivekanand, D; Singh, Tanveer; Saurav,

doi:10.1016/j.mjafi.2020.03.003

Cited by 5 publications

(4 citation statements)

References 14 publications

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“…This may be due to the impairment of patient comfort caused by intrathecal morphine-related postoperative itching, PONV. The results of another study, in which only a local anesthetic was used for spinal anesthesia, were similar to ours [ 15 ].…”

Section: Discussionsupporting

confidence: 85%

The Impact of Preoperative Dexamethasone Administration on Quality of Recovery Following Laparoscopic Sleeve Gastrectomy: A Prospective Observational Study

Taflan,

Ustun,

Turunc

et al. 2024

OBES SURG

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Introduction Recovery from anesthesia is complex and affected by multiple factors. In patient with obesity, the increased prevalence of anxiety and depressive disorders poses a challenge in achieving optimal patient satisfaction. Therefore, strategies to enhance the quality of recovery are crucial for this population. This study aimed to investigate whether administration of dexamethasone to patients undergoing laparoscopic sleeve gastrectomy (LSG) could improve recovery outcomes. Methods This prospective observational study was conducted at a tertiary university hospital in Samsun, Turkey. Thirty patients who received dexamethasone prior to LSG (group D) and 30 patients who did not (group C) were included with convenience sampling method. The quality of recovery was assessed using the Quality of Recovery 40 questionnaire (QoR-40). The primary outcome measure was the QoR-40 score at 24 h postoperatively. Results The dexamethasone group showed a significant improvement in QoR-40 scores (185.4 ± 6.0 vs. 172.0 ± 8.4, p < 0.001), exhibited reduced morphine consumption (11.8 ± 7.8 vs. 21.8 ± 10.9 mg, p < 0.001), opioid demand count (21.50 [9.50–49.00], p = 0.001), the number of patient used antiemetic drug (1 vs. 22, p < 0.001), and achieved earlier mobilization (3 [3–4] vs. 3 [3–4] h, p < 0.0001). However, no significant differences were observed between the two groups concerning intraoperative complications, postoperative wound infections, or time to discharge. Conclusions In patients undergoing laparoscopic sleeve gastrectomy, preoperative dexamethasone administration was associated with improved the recovery quality after discharge and reduced early postoperative need for antiemetic medications. Graphical Abstract

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Section: Discussionsupporting

confidence: 85%

The Impact of Preoperative Dexamethasone Administration on Quality of Recovery Following Laparoscopic Sleeve Gastrectomy: A Prospective Observational Study

Taflan,

Ustun,

Turunc

et al. 2024

OBES SURG

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“…The effectiveness of IV dexamethasone on the prolongation of spinal anesthesia and postoperative analgesia in women undergoing cesarean delivery is the subject of eight RCT studies that are presented in the chosen journal articles from different countries (Table 3). [9][10][11][12]16…”

Section: Resultsmentioning

confidence: 99%

“…5,17 Multiple studies have demonstrated that administration of dexamethasone 8 mg intravenously extends the duration of postoperative analgesia spinal anesthesia after cesarean section and decreases postoperative opioid consumption. 9,10,12 Patients who underwent cesarean sections with spinal anesthesia benefit from preoperative dexamethasone 0.1 mg/kg intravenous administration because it reduces pain following surgery (intensity of postoperative pain) by lengthening the sensory receptor block, reduces opioid taken in its entirety on the first postoperative day, and reduces other analgesic requirement; it improves sleep the night after surgery; and a single dose has no impact on the prevalence of surgical site infection or wound healing. 5,16…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Single Intravenous Dexamethasone in Prolongation of Spinal Anesthesia for Postoperative Analgesia in Elective Cesarean Section: A Systematic Review of Randomized Controlled Trials

Abebe,

Alemu,

Teku

et al. 2024

JPR

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Background The analgesic effectiveness of a single perioperative dose of dexamethasone is not clearly defined. The administration of systemic medication like dexamethasone, opioids, and non-steroidal anti-inflammatory drugs has a positive effect on the prolongation of postoperative analgesia after cesarean section under spinal anesthesia. A single-dose administration of dexamethasone with moderate to high dose reduces postoperative pain, reduces opioid consumption, and prolongs spinal anesthesia after cesarean delivery. Objective The aim of this systematic review was to investigate the effectiveness of single intravenous dexamethasone in prolongation of spinal anesthesia for postoperative analgesia in elective cesarean section. Methods We conducted a search on PubMed, Google Scholar, the Cochrane Library, Hinari, and review articles on the effectiveness of intravenous dexamethasone for extending spinal anesthesia during elective cesarean sections, until June 2023. The searches were conducted by using keyword (IV dexamethasone OR/AND analgesia OR postoperative pain AND cesarean section OR child birth AND prolongation of spinal anesthesia). The articles included describe the analgesic efficacy of dexamethasone for prolongation of spinal anesthesia during cesarean section. Results A total of 25,384 papers were found using different searching methodologies from different electronic databases. The EndNote reference manager was used to remove duplicates, and 438 articles were selected for screening. Of those, 57 were included for critical evaluation, and 49 were removed with justification. The effectiveness of IV dexamethasone on the prolongation of spinal anesthesia and postoperative analgesia in women undergoing cesarean delivery is the subject of eight RCT studies on 628 parturients that are presented in the chosen journal articles from various countries. Conclusion Intravenous dexamethasone administration immediately after clamping of the umbilical cord prolongs the duration of spinal block in patients undergoing cesarean sections and has a significant impact on reduction of postoperative pain severity, opioid consumption, and other pain requirements. When high-dose dexamethasone is administered intravenously, it can overcome complications that may arise after severe pain and increase patient satisfaction by extending the duration of postoperative analgesia and sensory block.

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“…Four randomized controlled trials evaluated the use of intravenous dexamethasone 8-10 mg [122][123][124][125]. e results revealed that intravenous dexamethasone reduced modest pain scores, improved patient recovery outcomes [126], and prolonged postoperative analgesia [122] in patients undergoing cesarean section under spinal anesthesia. A metaanalysis of patients who received neuraxial morphine, including four trials of cesarean delivery and four abdominal hysterectomies, showed that a single dose of dexamethasone decreased pain scores compared with the placebo (mean difference (95% CI � −0.30 (−0.46, −0.13)) and reduced the use of rescue analgesics (RR (95% CI) � 0.72 (0.52, 0.98)) [127].…”

Section: Steroidsmentioning

confidence: 99%

The Current Consideration, Approach, and Management in Postcesarean Delivery Pain Control: A Narrative Review

Sangkum

Thamjamrassri

Arnuntasupakul

et al. 2021

Anesthesiology Research and Practice

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Optimal postoperative analgesia has a significant impact on patient recovery and outcomes after cesarean delivery. Multimodal analgesia is the core principle for cesarean delivery and pain management. For a standard analgesic regimen, the use of long-acting neuraxial opioids (e.g., morphine) and adjunct drugs, such as scheduled acetaminophen and nonsteroidal anti-inflammatory drugs, is recommended unless contraindicated. Oral or intravenous opioids should be reserved for breakthrough pain. In addition to the aforementioned use of multimodal analgesia, preoperative evaluation is critical to individualize the analgesic regimen according to the patient requirements. Risk factors for severe postoperative pain or analgesia-related adverse effects will require modifications to the standard analgesic regimen (e.g., the use of ketamine, gabapentinoids, or regional anesthetic techniques). Further investigation is required to determine analgesic drugs or dose alterations based on preoperative predictions for patients at risk of severe pain. Outcomes beyond pain and analgesic use, such as functional recovery, should be determined to evaluate analgesic treatment protocols.

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Evaluation of quality of recovery score in mothers and neonatal outcome assessment after surgery using preoperative dexamethasone for caesarean section

Cited by 5 publications

References 14 publications

The Impact of Preoperative Dexamethasone Administration on Quality of Recovery Following Laparoscopic Sleeve Gastrectomy: A Prospective Observational Study

The Impact of Preoperative Dexamethasone Administration on Quality of Recovery Following Laparoscopic Sleeve Gastrectomy: A Prospective Observational Study

Effectiveness of Single Intravenous Dexamethasone in Prolongation of Spinal Anesthesia for Postoperative Analgesia in Elective Cesarean Section: A Systematic Review of Randomized Controlled Trials

The Current Consideration, Approach, and Management in Postcesarean Delivery Pain Control: A Narrative Review

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