Hyperglycemic Response of Non-diabetic Women Undergoing Abdominal Hysterectomy Who Have Received Prophylactic Dexamethasone to Alleviate Nausea and Vomiting
Background: This study has been designed to assess the hyperglycemic response in non-diabetic patients in women undergoing abdominal hysterectomy; who have received a prophylactic dose of dexamethasone to alleviate post-operative nausea and vomiting (PONV).
Methods: This was a double blind randomized clinical trial involving seventy women who were candidates for abdominal hysterectomy. The women were randomly assigned into two groups. Group A received 8mgs (in 50 mls normal saline) of IV dexamethasone; post-anesthetic induction and pre-surgery. Group B received 50 mls of normal saline post-anesthetic induction and pre-surgery. Patients were asked whether they had any nausea and vomiting during recovery. The patients’ blood sugar (BS) levels were assessed before surgery, during recovery and then 1, 6, 12, 18, and 24 hours after surgery.
Results: Thirty-three women in each group were monitored. Assessment of the results indicates that nausea and vomiting were not significantly different between the two groups. The age and BS before surgery of the patients were not significantly different. BS levels after surgery were significantly higher for the group receiving dexamethasone; with the exception of the levels during the first hour.
Conclusion: The BS of women undergoing abdominal hysterectomy is significantly higher for those receiving a single dose of dexamethasone, post-operatively, compared to patients receiving a placebo. The finding of this study does not support the role of dexamethasone in the prophylactic anti-emetic treatment in abdominal hysterectomy.
 Golembiewski J, Chernin E, Chopra T. Prevention and treatment of postoperative nausea and vomiting. Am J Health Syst Pharm. 2005; 62(12):1247-60.
 Amiri AA, Karvandian K, Rahimi M, Ashouri M, Amiri AA. Postoperative Nausea and Vomiting and Postoperative Pain in Patients Undergoing Elective Laparoscopy; Comparison of Total Intravenous Anesthesia versus Inhalational Anesthesia; A Randomized Clinical Trial. Arch Anesth and Critical Care. 2020; 6(2):71-7.
 Shaikh SI, Nagarekha D, Hegade G, Marutheesh M. Postoperative nausea and vomiting: A simple yet complex problem. Anesth Essays Res. 2016; 10(3):388-396.
 Selzer A, Pryor KO, Tangel V, O'Connell K, Kjaer K. The effect of intravenous dexamethasone on postoperative nausea and vomiting after Cesarean delivery with intrathecal morphine: a randomized-controlled trial. Can J Anaesth. 2020 Jul;67(7):817-826.
 Ho CM, Wu HL, Ho ST, Wang JJ. Dexamethasone prevents postoperative nausea and vomiting: benefit versus risk. Acta Anaesthesiol Taiwan. 2011; 49(3):100-4.
 Kalava A, Darji SJ, Kalstein A, Yarmush JM, SchianodiCola J, Weinberg J. Efficacy of ginger on intraoperative and postoperative nausea and vomiting in elective cesarean section patients. Eur J Obstet Gynecol Reprod Biol. 2013; 169(2):184-8.
 Ali Khan S, McDonagh DL, Gan TJ. Wound complications with dexamethasone for postoperative nausea and vomiting prophylaxis: a moot point? Anesth Analg. 2013; 116(5):966-8.
 Becker DE. Nausea, vomiting, and hiccups: a review of mechanisms and treatment. Anesth Prog. 2010; 57(4):150-6.
 Nazar CE, Lacassie HJ, López RA, Muñoz HR. Dexamethasone for postoperative nausea and vomiting prophylaxis: effect on glycaemia in obese patients with impaired glucose tolerance. Eur J Anaesthesiol. 2009; 26(4):318-21.
 Herbst RA, Telford OT, Hunting J, Bullock WM, Manning E, Hong BD, D'Alessio DA, Setji TL. THE EFFECTS OF PERIOPERATIVE DEXAMETHASONE ON GLYCEMIC CONTROL AND POSTOPERATIVE OUTCOMES. Endocr Pract. 2020; 26(2):218-25.
 Eberhart LH, Graf J, Morin AM, Stief T, Kalder M, Lattermann R, Schricker T. Randomised controlled trial of the effect of oral premedication with dexamethasone on hyperglycaemic response to abdominal hysterectomy. Eur J Anaesthesiol. 2011; 28(3):195-201.
 Ahmad R, Changeez M, Tameez Ud Din A, Iftikhar A, Ahmad HB, Mujtaba A, et al. Role of Prophylactic Dexamethasone Before Thyroidectomy in Reducing Postoperative Pain, Nausea and Vomiting. Cureus. 2019; 11(5):e4735.
 Murphy GS, Szokol JW, Greenberg SB, Avram MJ, Vender JS, Nisman M, et al. Preoperative Dexamethasone Enhances Quality of Recovery after Laparoscopic Cholecystectomy Effect on In-hospital and Post discharge Recovery Outcomes. Anesthesiology. 2011; 114(4):882-90.
 Thangaswamy CR, Rewari V, Trikha A, Dehran M, Chandralekha. Dexamethasone before total laparoscopic hysterectomy: a randomized controlled dose-response study. J Anesth. 2010; 24(1):24-30.
 Sekhavat L, Davar R, Behdad S. Efficacy of prophylactic dexamethasone in prevention of postoperative nausea and vomiting. J Epidemiol Glob Health. 2015; 5(2):175-9.
 Tzeng JI, Hsing CH, Chu CC, Chen YH, Wang JJ. Low-dose dexamethasone reduces nausea and vomiting after epidural morphine: a comparison of metoclopramide with saline. J Clin Anesth. 2002; 14(1):19-23.
 Umpierrez GE, Isaacs SD, Bazargan N, You X, Thaler LM, Kitabchi AE. Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab. 2002; 87(3):978-82.
|Issue||Vol 6 No 4 (2020): Autumn|
|Abdominal hysterectomy Dexamethasone Nausea and vomiting Blood sugar|
|Rights and permissions|
|This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.|