A Single Perioperative Injection of Dexamethasone Decreases Nausea, Vomiting, and Pain after Laparoscopic Donor Nephrectomy

Background. A single dose of perioperative dexamethasone (8–10 mg) reportedly decreases postoperative nausea, vomiting, and pain but has not been widely used in laparoscopic donor nephrectomy (LDN). Methods. We performed a retrospective cohort study of living donors who underwent LDN between 2013 an...

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Main Authors: Shigeyoshi Yamanaga, Andrew Mark Posselt, Chris Earl Freise, Takaaki Kobayashi, Mehdi Tavakol, Sang-Mo Kang
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Journal of Transplantation
Online Access:http://dx.doi.org/10.1155/2017/3518103
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author Shigeyoshi Yamanaga
Andrew Mark Posselt
Chris Earl Freise
Takaaki Kobayashi
Mehdi Tavakol
Sang-Mo Kang
author_facet Shigeyoshi Yamanaga
Andrew Mark Posselt
Chris Earl Freise
Takaaki Kobayashi
Mehdi Tavakol
Sang-Mo Kang
author_sort Shigeyoshi Yamanaga
collection DOAJ
description Background. A single dose of perioperative dexamethasone (8–10 mg) reportedly decreases postoperative nausea, vomiting, and pain but has not been widely used in laparoscopic donor nephrectomy (LDN). Methods. We performed a retrospective cohort study of living donors who underwent LDN between 2013 and 2015. Donors who received a lower dose (4–6 mg)  (n=70) or a higher dose (8–14 mg) of dexamethasone (n=100) were compared with 111 donors who did not receive dexamethasone (control). Outcomes and incidence of postoperative nausea, vomiting, and pain within 24 h after LDN were compared before and after propensity-score matching. Results. The higher dose of dexamethasone reduced postoperative nausea and vomiting incidences by 28% (P=0.010) compared to control, but the lower dose did not. Total opioid use was 29% lower in donors who received the higher dose than in control (P=0.004). The higher dose was identified as an independent factor for preventing postoperative nausea and vomiting. Postoperative complication rates and hospital stays did not differ between the groups. After propensity-score matching, the results were the same as for the unmatched analysis. Conclusion. A single perioperative injection of 8–14 mg dexamethasone decreases antiemetic and narcotic requirements in the first 24 h, with no increase in surgical complications.
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spelling doaj-art-d1cc2f6b692f464690b9ba802686b5562025-02-03T06:07:24ZengWileyJournal of Transplantation2090-00072090-00152017-01-01201710.1155/2017/35181033518103A Single Perioperative Injection of Dexamethasone Decreases Nausea, Vomiting, and Pain after Laparoscopic Donor NephrectomyShigeyoshi Yamanaga0Andrew Mark Posselt1Chris Earl Freise2Takaaki Kobayashi3Mehdi Tavakol4Sang-Mo Kang5Division of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA, USADivision of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA, USADivision of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA, USADepartment of Renal Transplant Surgery, Aichi Medical University School of Medicine, Nagakute, Aichi, JapanDivision of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA, USADivision of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA, USABackground. A single dose of perioperative dexamethasone (8–10 mg) reportedly decreases postoperative nausea, vomiting, and pain but has not been widely used in laparoscopic donor nephrectomy (LDN). Methods. We performed a retrospective cohort study of living donors who underwent LDN between 2013 and 2015. Donors who received a lower dose (4–6 mg)  (n=70) or a higher dose (8–14 mg) of dexamethasone (n=100) were compared with 111 donors who did not receive dexamethasone (control). Outcomes and incidence of postoperative nausea, vomiting, and pain within 24 h after LDN were compared before and after propensity-score matching. Results. The higher dose of dexamethasone reduced postoperative nausea and vomiting incidences by 28% (P=0.010) compared to control, but the lower dose did not. Total opioid use was 29% lower in donors who received the higher dose than in control (P=0.004). The higher dose was identified as an independent factor for preventing postoperative nausea and vomiting. Postoperative complication rates and hospital stays did not differ between the groups. After propensity-score matching, the results were the same as for the unmatched analysis. Conclusion. A single perioperative injection of 8–14 mg dexamethasone decreases antiemetic and narcotic requirements in the first 24 h, with no increase in surgical complications.http://dx.doi.org/10.1155/2017/3518103
spellingShingle Shigeyoshi Yamanaga
Andrew Mark Posselt
Chris Earl Freise
Takaaki Kobayashi
Mehdi Tavakol
Sang-Mo Kang
A Single Perioperative Injection of Dexamethasone Decreases Nausea, Vomiting, and Pain after Laparoscopic Donor Nephrectomy
Journal of Transplantation
title A Single Perioperative Injection of Dexamethasone Decreases Nausea, Vomiting, and Pain after Laparoscopic Donor Nephrectomy
title_full A Single Perioperative Injection of Dexamethasone Decreases Nausea, Vomiting, and Pain after Laparoscopic Donor Nephrectomy
title_fullStr A Single Perioperative Injection of Dexamethasone Decreases Nausea, Vomiting, and Pain after Laparoscopic Donor Nephrectomy
title_full_unstemmed A Single Perioperative Injection of Dexamethasone Decreases Nausea, Vomiting, and Pain after Laparoscopic Donor Nephrectomy
title_short A Single Perioperative Injection of Dexamethasone Decreases Nausea, Vomiting, and Pain after Laparoscopic Donor Nephrectomy
title_sort single perioperative injection of dexamethasone decreases nausea vomiting and pain after laparoscopic donor nephrectomy
url http://dx.doi.org/10.1155/2017/3518103
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