Evidence map›Paper›PMID 23220857›Full record

SynthesisBritish journal of anaesthesia2013

Impact of perioperative dexamethasone on postoperative analgesia and side-effects: systematic review and meta-analysis.

N H Waldron, C A Jones, T J Gan, T K Allen, A S Habib

7 registry-linked trialsOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of anaesthesia, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 7 registered trials, which are not on this map. Cited by 203 papers, 21 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
203citing papers in PubMed, 21 pooled it
32.9field-weighted citation impact, top 1% 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.

NCT02666443 naunknown statusnot on this mapstarted 2016, after this paper: background citation

Low Dose Dexamethasone as an Adjuvant to Supraclavicular Brachial Plexus Blocks: A Prospective Randomized, Double Blinded, Control Study

TypeinterventionalSponsorUniversity of CalgaryRan2016 to 2021Enrolled306ConditionsRheumatoid Arthritis, Osteoarthritis, Nerve Entrapment, Ligament InjuryArmsControl intervention (no dexamethasone), Peri-neural Dexamethasone 1 mg, Intravenous Dexamethasone 1 mg
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%
NCT03270033 phase4completednot on this mapstarted 2017, after this paper: background citation

Analgesic Duration of Interscalene Block After Outpatient Arthroscopic Shoulder Surgery With Intravenous Dexamethasone, Dexmedetomidine or Their Combination: A Randomized Controlled Trial

TypeinterventionalSponsorUniversity of ManitobaRan2017 to 2018Enrolled198ConditionsPain, Postoperative, Shoulder Joint Disorder, Ambulatory Surgical Procedures, Brachial Plexus BlockArmsDexamethasone, Dexmedetomidine
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
NCT04325984 completednot on this mapstarted 2017, after this paper: background citation

Ruolo Del Desametasone Per il Controllo Multimodale Del Dolore Postoperatorio in Chirurgia Toracica

TypeobservationalSponsorUniversity of TriesteRan2017 to 2019Enrolled62ConditionsDexamethasone Adverse Reaction, Postoperative Pain, Postoperative Thoracic Procedure Complication, AnalgesiaArmsDexamethasone
NCT04624360 phase4unknown statusnot on this mapstarted 2020, after this paper: background citation

Randomised Controlled Trial Comparing the Effect of Intravenous Dexamethasone vs. Placebo on the Duration of Analgesia of Spinal Anaesthesia for Caesarean Sections at the Victoria Jubilee Hospital in Jamaica

TypeinterventionalSponsorThe University of The West IndiesRan2020 to 2020Enrolled60ConditionsPain, PostoperativeArmsDexamethasone, Placebo
NCT05287035 early_phase1unknown statusnot on this mapstarted 2023, after this paper: background citation

Perioperative IV Steroid Administration Lowers Post-operative Pain Levels and Opioid Use in Pediatric Patients After Posterior Spinal Fusion and Instrumentation for Spine Deformity.

TypeinterventionalSponsorUniversity of Texas at AustinRan2023 to 2025Enrolled70ConditionsSpinal FusionArmsDexamethasone injection, Saline injection
3 · Its place in the literature

Who cites it

203 citing papers in PubMed, 21 syntheses or guidelines pooled it, 637 citations in OpenAlex.

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  11. Adverse side effects of dexamethasone in surgical patients.The Cochrane database of systematic reviews · 2018
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  12. Adverse side effects of dexamethasone in surgical patients.The Cochrane database of systematic reviews · 2018
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  15. Dexamethasone as an adjuvant to peripheral nerve block.The Cochrane database of systematic reviews · 2017
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143 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

5 authors at 1 institution in 1 country.

N H WaldronDepartment of Anesthesiology, Duke University Medical Center, Box 3094, Durham, NC 27710, USA.
C A Jones
T J Gan
T K Allen
A S Habib
Duke University Hospital · US

Funding

Duke CTSITL1RR024126 · NCRR · DUKE UNIVERSITY · PI CALIFF, ROBERT M · 2006 to 2010
$2.2M
NCRR NIH HHS TI1 RR024126
6 · The paper itself

Abstract

backgroundThe analgesic efficacy and adverse effects of a single perioperative dose of dexamethasone are unclear. We performed a systematic review to evaluate the impact of a single i.v. dose of dexamethasone on postoperative pain and explore adverse events associated with this treatment.

methodsMEDLINE, EMBASE, CINAHL, and the Cochrane Register were searched for randomized, controlled studies that compared dexamethasone vs placebo or an antiemetic in adult patients undergoing general anaesthesia and reported pain outcomes.

resultsForty-five studies involving 5796 patients receiving dexamethasone 1.25-20 mg were included. Patients receiving dexamethasone had lower pain scores at 2 h {mean difference (MD) -0.49 [95% confidence interval (CI): -0.83, -0.15]} and 24 h [MD -0.48 (95% CI: -0.62, -0.35)] after surgery. Dexamethasone-treated patients used less opioids at 2 h [MD -0.87 mg morphine equivalents (95% CI: -1.40 to -0.33)] and 24 h [MD -2.33 mg morphine equivalents (95% CI: -4.39, -0.26)], required less rescue analgesia for intolerable pain [relative risk 0.80 (95% CI: 0.69, 0.93)], had longer time to first dose of analgesic [MD 12.06 min (95% CI: 0.80, 23.32)], and shorter stays in the post-anaesthesia care unit [MD -5.32 min (95% CI: -10.49 to -0.15)]. There was no dose-response with regard to the opioid-sparing effect. There was no increase in infection or delayed wound healing with dexamethasone, but blood glucose levels were higher at 24 h [MD 0.39 mmol litre(-1) (95% CI: 0.04, 0.74)].

conclusionsA single i.v. perioperative dose of dexamethasone had small but statistically significant analgesic benefits.

Indexed as

Analgesics, OpioidAnesthesia, GeneralAnesthesia Recovery PeriodAnti-Inflammatory AgentsConfidence IntervalsDexamethasoneEndpoint DeterminationFemaleHumansMalePain MeasurementPostoperative PainRiskTreatment OutcomeAnalgesics, OpioidAnti-Inflammatory AgentsDexamethasone

Identifiers

PMID23220857
PMCPMC3544008
OpenAlexW2164803788

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

and 1 more above

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.