Evidence map›Paper›PMID 11085349›Full record

SynthesisDrug safety2000

Risks and benefits of preoperative high dose methylprednisolone in surgical patients: a systematic review.

S Sauerland, M Nagelschmidt, P Mallmann, E A Neugebauer

5 registry-linked trialsAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Drug safety, 2000. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 74 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
74citing papers in PubMed, 14 pooled it
2.9field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00307606 phase4unknown statusnot on this mapstarted 2005, after this paper: background citation

Does a Single Steroid Injection Reduce the Formation of Postmastectomy Seroma

TypeinterventionalSponsorHerlev HospitalRan2005 to 2007Enrolled40ConditionsBreast Neoplasms, MastectomyArmsSolu-medrol 125 mg
NCT01106547 phase4completednot on this mapstarted 2009, after this paper: background citation

The Effect of a Preoperative Single-dose Methylprednisolone on the Postoperative Rehabilitation After Abdominal Hysterectomy: A Prospective, Double Blinded, Placebo Controlled Study

TypeinterventionalSponsorHolbaek SygehusRan2009 to 2011Enrolled55ConditionsHysterectomy, Methylprednisolone, Postoperative PainArmsMethylprednisolone 125mg, Sodium Chloride 2 ml
NCT03034733 phase4terminatednot on this mapstarted 2017, after this paper: background citation

The Effect of Intravenous Single-dose Dexamethasone on Pain After Total Knee Replacement Surgery

TypeinterventionalSponsorUniversity of OuluRan2017 to 2018Enrolled27ConditionsArthroplasty, Knee Replacement, Pain, PostoperativeArmsDexamethasone, Sodium Chloride, (24)NaCl 0,9%
NCT03901768 phase4unknown statusnot on this mapstarted 2018, after this paper: background citation

Effects of Combined Topical and Systemic Steroid Administrations on Better Early Postoperative Pain Management in Total Knee Arthroplasty: a Prospective Double-blinded Placebo Controlled Randomised Clinical Trial

TypeinterventionalSponsorThe University of Hong KongRan2018 to 2021Enrolled180ConditionsTotal Knee ReplacementArmsDexamethasone, Triamcinolone, Placebos
NCT05113901 phase4terminatednot on this mapstarted 2022, after this paper: background citation

Methylprednisolone Taper to Treat Delayed Post-Operative Recovery After Total Knee Arthroplasty: a Double-Blind Randomized Controlled Trial

TypeinterventionalSponsorRush University Medical CenterRan2022 to 2022Enrolled4ConditionsTotal Knee ArthroplastyArmsMethylprednisolone, Placebo
3 · Its place in the literature

Who cites it

74 citing papers in PubMed, 14 syntheses or guidelines pooled it, 227 citations in OpenAlex.

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  8. The efficacy of steroid injection in total knee or hip arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2015
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  10. Dexamethasone reduces nausea and vomiting but not pain after thyroid surgery: a meta-analysis of randomized controlled trials.Medical science monitor : international medical journal of experimental and clinical research · 2014
    Pooled it
  11. Steroids for traumatic optic neuropathy.The Cochrane database of systematic reviews · 2013
    Pooled it
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  13. Steroids for acute spinal cord injury.The Cochrane database of systematic reviews · 2012
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14 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

S Sauerland2nd Department of Surgery, University of Cologne, Germany. S.Sauerland@uni-koeln.de
M Nagelschmidt
P Mallmann
E A Neugebauer
University of Cologne · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA single preoperative high dose of methylprednisolone (15 to 30 mg/kg) has been advocated in surgery, because it may inhibit the surgical stress response and thereby improve postoperative outcome and convalescence. However, these potential clinical benefits must be weighed against possible adverse effects.

objectiveTo conduct a risk-benefit analysis using a meta-analysis, to compare complication rates and clinical advantages associated with the use of high dose methylprednisolone in surgical patients.

methodsRandomised controlled trials of high dose methylprednisolone in elective and trauma surgery were systematically searched for in various literature databases. Outcome data on adverse effects, postoperative pain and hospital stay were extracted and statistically pooled in fixed-effects meta-analyses.

resultsWe located 51 studies in elective cardiac and noncardiac surgery, as well as traumatology. Pooled data failed to show any significant increase in complication rates. In patients treated with corticosteroids, nonsignificantly more gastrointestinal bleeding and wound complications were observed; the 95% confidence interval boundaries of the numbers-needed-to-harm were 59 and 38, respectively. The only significant finding was a reduction of pulmonary complications (risk difference -3.5%; 95% confidence interval -1.0 to -6.1), mainly in trauma patients.

conclusionFor patients undergoing surgical procedures, a perioperative single-shot administration of high dose methylprednisolone is not associated with a significant increase in the incidence of adverse effects. In patients with multiple fractures, limited evidence suggests promising benefits of glucocorticoids on pulmonary complications.

Indexed as

PremedicationPreoperative CareAnimalsAnti-Inflammatory AgentsHumansMethylprednisolone HemisuccinateRandomized Controlled Trials as TopicRisk AssessmentTreatment OutcomeAnti-Inflammatory AgentsMethylprednisolone Hemisuccinate

Identifiers

PMID11085349
OpenAlexW1993695930

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.