The effects of single‐dose dexamethasone on inflammatory response and pain after uterine artery embolisation for symptomatic fibroids or adenomyosis: a randomised controlled study

Abstract

Objective To investigate the effects of single-dose intravenous dexamethasone on inflammatory responses, pain, nausea, and vomiting after uterine artery embolisation (UAE).Design Prospective, randomised, double-blind, and placebocontrolled study.Setting Tertiary-care University centre in Korea.Population Patients undergoing UAE for the treatment of symptomatic fibroids or adenomyosis.Methods Patients were randomised to receive either intravenous dexamethasone (10 mg; dexamethasone group) or normal saline (control group) 1 hour before UAE. Both groups received fentanyl-based intravenous patient-controlled analgesia (PCA) during the 24 hours after UAE.Main outcome measures The primary outcomes were the inflammatory and stress responses measured by white blood cell count, neutrophil percentage, C-reactive protein (CRP), interleukin-6 (IL-6), and cortisol. Secondary outcomes were severity of pain and incidence of nausea and vomiting.Results Sixty-four patients were enrolled and 59 patients completed the study. CRP, IL-6, and cortisol were significantly lower in the dexamethasone group compared with the control group during the 24 hours after UAE. Although the cumulative dose of fentanyl and additional analgesics administered during the 24 hours after UAE were similar between the two groups, pain scores were significantly lower in the dexamethasone group from 12 hours after UAE, and the incidence of severe nausea and vomiting was lower in the dexamethasone group. ConclusionsThe administration of single-dose intravenous dexamethasone as an adjunct to fentanyl-based intravenous PCA is effective in reducing inflammation and pain during the first 24 hours after UAE.

Hydromorphone Hydrochloride Use During Various Interventional Radiology Procedures—Pain Control and Adverse Events: A Case Series Audit Analysis

“…Only 22 of the 100 patients in this study underwent procedures considered to be relatively more painful (biliary interventions, bone biopsies, embolizations, percutaneous nephrostomies, percutaneous nephrolithotomy access placement). On a similar note, only four of our cases were embolization procedures, whereupon our literature search showed most of the literature regarding pain control and interventional radiology procedures were for uterine artery embolization and chemoembolization [ 13 – 19 ]. A larger cohort of patients undergoing more painful procedures would give a better estimate of hydromorphone’s true analgesic ability in procedural IR settings.…”

Perioperative glucocorticoids are associated with improved long-term survival after pancreatic cancer surgery: A retrospective cohort study

“…Glucocorticoids have a broad-spectrum anti-inflammatory effect [29]. In a randomized controlled trial by Kim et al, a single-dose dexamethasone (10 mg) significantly relieved the degree of inflammation within 24 hours after uterine arterial embolization [30]. Along with the anti-inflammatory effect, glucocorticoids can modulate immune function by suppressing the Th1-cellular immunity axis and augmenting the Th2-mediated humoral immunity, which may provide protection against surgical stress [28,31].…”

Perioperative analgesia with a buprenorphine transdermal patch for hallux valgus surgery: a prospective, randomized, controlled study

“… 19 Preoperative dexamethasone, either given orally or given intravenously, has been found to reduce both the opioid consumption and the time to discharge; moreover, it reduces the incidence of nausea and is known to be an effective antiemetic. 20 …”