Evidence map›Paper›PMID 36759373›Full record

SynthesisInternational journal of colorectal disease2023

Perioperative intravenous dexamethasone for patients undergoing colorectal surgery: a systematic review and meta-analysis.

Tyler McKechnie, Geoffrey Elder, Simarpreet Ichhpuniani, Andrew T Chen, Kathleen Logie, Aristithes Doumouras, Dennis Hong, Randy Benko, Cagla Eskicioglu

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in International journal of colorectal disease, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 14% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Review
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

9 authors at 2 institutions in 1 country.

Tyler McKechnieDivision of General Surgery, Department of Surgery, McMaster University, Hamilton, ON, L8N 4A6, Canada.
Geoffrey ElderMichael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, L8N 4A6, Canada.
Simarpreet IchhpunianiMichael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, L8N 4A6, Canada.
Andrew T ChenMichael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, L8N 4A6, Canada.
Kathleen LogieDivision of General Surgery, Department of Surgery, McMaster University, Hamilton, ON, L8N 4A6, Canada.
Aristithes DoumourasDivision of General Surgery, Department of Surgery, McMaster University, Hamilton, ON, L8N 4A6, Canada.
Dennis HongDivision of General Surgery, Department of Surgery, McMaster University, Hamilton, ON, L8N 4A6, Canada.
Randy BenkoDepartment of Anesthesia, McMaster University, Hamilton, ON, Canada.
Cagla EskiciogluDivision of General Surgery, Department of Surgery, McMaster University, Hamilton, ON, L8N 4A6, Canada. eskicio@mcmaster.ca.
McMaster University · CASt. Joseph’s Healthcare Hamilton · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeDexamethasone is a glucocorticoid that is often administered intraoperatively as prophylaxis for postoperative nausea and vomiting (PONV). Several randomized controlled trials (RCTs) have examined its use in colorectal surgery. This systematic review aims to assess the postoperative impacts of dexamethasone use in colorectal surgery.

methodsMEDLINE, Embase, and CENTRAL were searched from database inception to January 2023. Articles were included if they compared perioperative intravenous dexamethasone to a control group in patients undergoing elective colorectal surgery in terms of postoperative morbidity. The primary outcomes were prolonged postoperative ileus (PPOI) and PONV. Secondary outcomes included postoperative infectious morbidity and return of bowel function. A pair-wise meta-analysis and GRADE assessment of the quality of evidence were performed.

resultsAfter reviewing 3476 relevant citations, seven articles (five RCTs, two retrospective cohorts) met the inclusion criteria. Overall, 1568 patients received perioperative dexamethasone and 1459 patients received a control. Patients receiving perioperative dexamethasone experienced significantly less PPOI based on moderate-quality evidence (three studies, OR 0.46, 95%CI 0.28-0.74, p < 0.01). Time to first flatus was significantly reduced with intravenous dexamethasone. There was no difference between groups in terms of PONV (four studies, OR 0.90, 95%CI 0.64-1.27, p = 0.55), postoperative morbidity (OR 0.93, 95%CI 0.63-1.39, p = 0.74), or rate of postoperative infectious complications (seven studies, OR 0.74, 95%CI 0.55-1.01, p = 0.06).

conclusionThis review presents moderate-quality evidence that perioperative intravenous dexamethasone may reduce PPOI and enhance the return of bowel function following elective colorectal surgery. There was no significant observed effect on PONV or postoperative infectious complications.

Indexed as

Colorectal SurgeryDigestive System Surgical ProceduresDexamethasoneGlucocorticoidsHumansPostoperative Nausea and VomitingDexamethasoneGlucocorticoidsColectomyColorectal surgeryDexamethasoneEnhanced recovery after surgeryPostoperative nausea and vomiting prophylaxis

Identifiers

PMID36759373
OpenAlexW4319815056

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.