September Anesthesiology News Briefs
(August 24, 2011)
A study and editorial published in the September issue of Anesthesiology
explore postoperative pain, one of the most common adverse events after surgery. They also analyze whether a non-opioid drug is effective in decreasing pain when administered before surgery.
The most common medication used to treat postoperative pain is opioids. However, this type of drug has a high risk for producing side effects such as nausea, vomiting, constipation, drowsiness and itching, leaving many patients to choose between adverse side effects and pain relief.
Dexamethasone, an anti-inflammatory steroid, is commonly used to prevent postoperative nausea and vomiting. Researchers from Northwestern University reviewed previously collected data from over 2700 patients to determine whether a slightly higher dose of the steroid would decrease postoperative pain. Their analysis showed that dexamethasone administered before surgery had a large effect in reducing pain, as well as the consumption of opioids after surgery.
“Postoperative pain is a major factor associated with poor patient satisfaction,” said lead study author Gildasio S. De Oliveira, Jr., M.D. “The use of dexamethasone can help patients reduce their amount of postoperative pain and side effects, likely resulting in higher patient satisfaction with their anesthesiologist and other health care providers.”
In an accompanying editorial by researchers from the Cleveland Clinic, the role of steroids on pain control after surgery was discussed. The editorial recognized that while there is good evidence that steroids ameliorate acute postoperative pain, the risk-benefit ratio remains unclear.
“The De Oliveira study is the most quantitative literature review of perioperative dexamethasone for pain,” said lead editorial author Alparslan Turan, M.D. “There is further work that could be done to evaluate if adverse events are associated with the use of steroids for postoperative pain management.”
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