The effect of dexamethasone in laparoscopic abdominal surgery - a review on inflammatory markers for stress response

Abstract Background We aimed to perform a review focused on the effects of dexamethasone on markers of surgical stress in the context of laparoscopic abdominal surgery. Methods This review was registered at PROSPERO. Published reports were evaluated with COVIDENCE, focusing on randomized controlled...

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Main Authors: Karsten Kaiser, Sven Hoedt Karstensen, Alexandros Nikolaou Valsamides Valorenzos, Kristian Als Nielsen, Thomas Strøm, Ismail Gögenur, Lukas Balsevicius, Finn Friis Lauszus
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Surgery
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Online Access:https://doi.org/10.1186/s12893-025-03061-x
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author Karsten Kaiser
Sven Hoedt Karstensen
Alexandros Nikolaou Valsamides Valorenzos
Kristian Als Nielsen
Thomas Strøm
Ismail Gögenur
Lukas Balsevicius
Finn Friis Lauszus
author_facet Karsten Kaiser
Sven Hoedt Karstensen
Alexandros Nikolaou Valsamides Valorenzos
Kristian Als Nielsen
Thomas Strøm
Ismail Gögenur
Lukas Balsevicius
Finn Friis Lauszus
author_sort Karsten Kaiser
collection DOAJ
description Abstract Background We aimed to perform a review focused on the effects of dexamethasone on markers of surgical stress in the context of laparoscopic abdominal surgery. Methods This review was registered at PROSPERO. Published reports were evaluated with COVIDENCE, focusing on randomized controlled trials from the MEDLINE, EMBASE and CENTRAL databases. Studies were included if they compared a single intravenous dose of dexamethasone to placebo given preoperatively to adult patients undergoing laparoscopic or robotic assisted abdominal surgery under general anesthesia. The outcome of interest was inflammatory response in general and in particular c-reactive protein. Results Out of 588 references, we included seven studies. These involved a variety of surgical procedures, with cholecystectomies being the most common, and included mixed gender populations except in studies on gynecology surgery. Due to the heterogeneity in outcomes and the low number of studies no meta-analysis was performed. Levels of c-reactive protein was 38-60 % lower at 24 to 48 hours postoperatively with a dose of 8 mg dexamethasone compared to placebo, predominantly in cholecystectomy cases. Post-trial calculation indicates that the power of these studies ranged between 60% and 95%. Conclusion Our review may indicate a reduction of surgical stress in laparoscopic abdominal surgery measured by c-reactive protein, when a single dose of dexamethasone is administered. Trial registration PROSPERO: CRD 42024421062.
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spelling doaj-art-8dfdab8748ba436ebfdafc0cfd1fabaf2025-08-20T03:04:21ZengBMCBMC Surgery1471-24822025-08-012511910.1186/s12893-025-03061-xThe effect of dexamethasone in laparoscopic abdominal surgery - a review on inflammatory markers for stress responseKarsten Kaiser0Sven Hoedt Karstensen1Alexandros Nikolaou Valsamides Valorenzos2Kristian Als Nielsen3Thomas Strøm4Ismail Gögenur5Lukas Balsevicius6Finn Friis Lauszus7Department of Gynecology and Obstetrics, Aabenraa Hospital, Sygehus SønderjyllandDepartment of Gynecology and Obstetrics, Aabenraa Hospital, Sygehus SønderjyllandDepartment of Gynecology and Surgery Aabenraa Hospital, Sygehus SønderjyllandDepartment of Gynecology and Surgery Aabenraa Hospital, Sygehus SønderjyllandDepartment of Anesthesia and Critical Care Medicine, Hospital Sønderjylland, University of Southern DenmarkDepartment of Surgery, Zealand University HospitalDepartment of Surgery, Zealand University HospitalDepartment of Gynecology and Obstetrics, Aabenraa Hospital, Sygehus SønderjyllandAbstract Background We aimed to perform a review focused on the effects of dexamethasone on markers of surgical stress in the context of laparoscopic abdominal surgery. Methods This review was registered at PROSPERO. Published reports were evaluated with COVIDENCE, focusing on randomized controlled trials from the MEDLINE, EMBASE and CENTRAL databases. Studies were included if they compared a single intravenous dose of dexamethasone to placebo given preoperatively to adult patients undergoing laparoscopic or robotic assisted abdominal surgery under general anesthesia. The outcome of interest was inflammatory response in general and in particular c-reactive protein. Results Out of 588 references, we included seven studies. These involved a variety of surgical procedures, with cholecystectomies being the most common, and included mixed gender populations except in studies on gynecology surgery. Due to the heterogeneity in outcomes and the low number of studies no meta-analysis was performed. Levels of c-reactive protein was 38-60 % lower at 24 to 48 hours postoperatively with a dose of 8 mg dexamethasone compared to placebo, predominantly in cholecystectomy cases. Post-trial calculation indicates that the power of these studies ranged between 60% and 95%. Conclusion Our review may indicate a reduction of surgical stress in laparoscopic abdominal surgery measured by c-reactive protein, when a single dose of dexamethasone is administered. Trial registration PROSPERO: CRD 42024421062.https://doi.org/10.1186/s12893-025-03061-xC-reactive proteinDexamethasoneLaparoscopyRandomized controlled trialInflammationReview
spellingShingle Karsten Kaiser
Sven Hoedt Karstensen
Alexandros Nikolaou Valsamides Valorenzos
Kristian Als Nielsen
Thomas Strøm
Ismail Gögenur
Lukas Balsevicius
Finn Friis Lauszus
The effect of dexamethasone in laparoscopic abdominal surgery - a review on inflammatory markers for stress response
BMC Surgery
C-reactive protein
Dexamethasone
Laparoscopy
Randomized controlled trial
Inflammation
Review
title The effect of dexamethasone in laparoscopic abdominal surgery - a review on inflammatory markers for stress response
title_full The effect of dexamethasone in laparoscopic abdominal surgery - a review on inflammatory markers for stress response
title_fullStr The effect of dexamethasone in laparoscopic abdominal surgery - a review on inflammatory markers for stress response
title_full_unstemmed The effect of dexamethasone in laparoscopic abdominal surgery - a review on inflammatory markers for stress response
title_short The effect of dexamethasone in laparoscopic abdominal surgery - a review on inflammatory markers for stress response
title_sort effect of dexamethasone in laparoscopic abdominal surgery a review on inflammatory markers for stress response
topic C-reactive protein
Dexamethasone
Laparoscopy
Randomized controlled trial
Inflammation
Review
url https://doi.org/10.1186/s12893-025-03061-x
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