Post-operative pain and inflammatory reaction reduced by injection of a corticosteroid

Skjelbred, Per; Løkken, P

doi:10.1007/bf00542325

Cited by 122 publications

(61 citation statements)

References 14 publications

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“…These results may be attributed to the anti-inflammatory effect produced by dexamethasone, which may reduce local edema and pain. These results on the analgesic effect of dexamethasone are in agreement with previous studies of dental 19,20 and ambulatory surgery. 21 Inconclusive results in other studies may be due to difficulties in standardizing perioperative clinical condition, the use of analgesics in the control groups and insensitive methods to assess pain.…”

Section: Figure 1 Median Children's Hospital Eastern Ontario Painsupporting

confidence: 82%

Dexamethasone reduces postoperative vomiting and pain after pediatric tonsillectomy

Elhakim

Rashed

et al. 2003

Can J Anesth/J Can Anesth

148

121

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P Pu ur rp po os se e: : Previous studies on dexamethasone's antiemetic and analgesic potential in children undergoing tonsillectomy have produced conflicting results. The aim of this study was to evaluate the effects of a single dose of dexamethasone on the incidence and severity of postoperative vomiting and pain in children undergoing electrocautery tonsillectomy under standardized general anesthesia. M Me et th ho od ds s: :In a double-blinded study, 120 patients were randomly allocated to receive either dexamethasone 0.5 mg·kg -1 (maximum dose 8 mg) iv or an equivalent volume of saline preoperatively. The incidence of early and late vomiting, need for rescue antiemetics, time to first oral intake, time to first demand of analgesia and analgesic consumption were compared in both groups. Pain scores used included Children's Hospital Eastern Ontario Pain Scale, "faces", and a 0-10 visual analogue pain scale.R Re es su ul lt ts s: : Compared with placebo, dexamethasone significantly decreased the incidence of early and late vomiting (P < 0.05, P < 0.001 respectively). Fewer patients in the dexamethasone group needed antiemetic rescue (P < 0.01). The time to first oral intake was shorter, and the time to first dose of analgesic was longer in the dexamethasone group (P < 0.01). Pain scores 30 min after extubation were lower (P < 0.05) in the dexamethasone group. At 12 and 24 hr postoperative swallowing was still significantly less painful in the dexamethasone group than in the control group (P < 0.01).C Co on nc cl lu us si io on n: : Preoperative dexamethasone 0.5 mg·kg -1 iv reduced both postoperative vomiting and pain in children after electrocautery tonsillectomy. ONSILLECTOMY is one of the most frequently performed ambulatory surgical procedures in children and is associated with an incidence of postoperative vomiting ranging between 40% and 73%. 1-3 The introduction of an electrodissection surgical technique has virtually eliminated immediate postoperative hemorrhage. However, it may cause more pain, discomfort Résultats : Comparée au placebo, la dexaméthasone a significativement réduit l'incidence de vomissements précoces et tardifs (P < 0,05, P < 0,001 respectivement). Peu de patients ayant reçu la dexaméthasone ont eu besoin d'antiémétique de secours (P < 0,01

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Section: Figure 1 Median Children's Hospital Eastern Ontario Painsupporting

confidence: 82%

Dexamethasone reduces postoperative vomiting and pain after pediatric tonsillectomy

Elhakim

Rashed

et al. 2003

Can J Anesth/J Can Anesth

148

121

View full text Add to dashboard Cite

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“…Oral invasive procedures like the most commonly performed surgical removal of the impacted third molars can give significant post-operative sequelae to the patient since the procedure may involve severe laceration and tissue trauma to soft and hard tissues surrounding it [10]. This can cause pain, swelling and limited mouth opening to the patients [11,12].…”

Section: Discussionmentioning

confidence: 99%

Randomized Controlled Trial to Evaluate the Efficacy of Oral Dexamethasone and Intramuscular Dexamethasone in Mandibular Third Molar Surgeries

Sabhlok

Kenjale²,

Mony³

et al. 2015

JCDR

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“…The cell number and activity of natural killer cells are diminished during induction and there is a change in the balance of pro-and anti-inflammatory cytokines. Corticosteroids are powerful drugs for inflammatory conditions, and parenteral administration of betamethasone, for example, can significantly reduce postoperative swelling and pain (11,28). Nonsteroidal antiinflammatory drugs (NSAIDs) are effective in reducing postoperative pain, but their modulating effect on the systemic inflammatory response after surgery is not satisfactory.…”

Section: Discussionmentioning

confidence: 99%

Clarithromycin Attenuates Mastectomy-Induced Acute Inflammatory Response

Chow¹,

Yuen

Woo

et al. 2000

Clin Diagn Lab Immunol

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Based on the observation that administration of clarithromycin led to an attenuation of the inflammatory response induced by surgical trauma in a guinea pig model, we investigated the potential beneficial effects of clarithromycin on the local and systemic inflammatory response in patients undergoing mastectomy in an open-label prospective study. During a 16-month period, 54 patients who underwent mastectomy were randomly divided into two groups. In one group, the patients received oral clarithromycin at a dose of 500 mg twice a day, from the day before to 3 days after mastectomy. There was no significant difference in the incidence of antibiotic prophylaxis-related toxicities or postoperative infections between the patients who received clarithromycin and those who did not. Clarithromycin treatment was significantly associated with an attenuation of febrile response, tachycardia, tachypnea, and an increase in monocyte counts (P, <0.0001, <0.01, <0.05, and <0.01, respectively). Clarithromycin also reduced the intensity and duration of postoperative pain (P, <0.05 and <0.005, respectively) and increased the range of motion of the involved shoulder (P < 0.05 for abduction and flexion). We conclude that clarithromycin effectively modulates the acute inflammatory response associated with mastectomy and produces a better clinical outcome.Surgical operations induce major physiological and immunological changes. These changes are activated by various stimuli, such as nociceptive stimulation, tissue injury, tissue ischemia, reperfusion, and hemodynamic disturbances. The clinical response is the result of complex changes, which include dysregulation of T-cell function, changes in the balance of cytokines and counterregulatory hormones, and increased hepatic synthesis of acute-phase reactants. In most patients, the systemic changes are minimal and self-limiting. However, in patients with complicated surgery or major trauma, the response becomes extensive and prolonged, resulting in systemic inflammatory response syndrome (SIRS), which is characterized by increased or suppressed body temperature, increased heart rate, hyperventilation, and an abnormal peripheral leukocyte count (2). Although an inflammatory response is an inevitable and essential part of the repair process and a natural defensive reaction to prevent infections associated with trauma, such undesirable fallout from surgical treatment is associated with significant morbidity and even mortality.The macrolide group of antibiotics is associated with in vitro and in vivo immunomodulating activities (18,(31)(32)(33). Erythromycin, one of the macrolides, has been used extensively for antimicrobial prophylaxis in colorectal surgery (22). Recently, it has also been shown that clarithromycin attenuates the inflammatory response induced by surgical trauma in a guinea pig model (32).Mastectomy is a suitable surgical procedure for the study of the acute inflammatory response to surgery because the extensive dissection causes significant tissue damage and bacterial contam...

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Post-operative pain and inflammatory reaction reduced by injection of a corticosteroid

Cited by 122 publications

References 14 publications

Dexamethasone reduces postoperative vomiting and pain after pediatric tonsillectomy

Dexamethasone reduces postoperative vomiting and pain after pediatric tonsillectomy

Randomized Controlled Trial to Evaluate the Efficacy of Oral Dexamethasone and Intramuscular Dexamethasone in Mandibular Third Molar Surgeries

Clarithromycin Attenuates Mastectomy-Induced Acute Inflammatory Response

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