JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) An erratum has been published Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (2) Citing Articles via Google Scholar Google Scholar Articles by Kjetil, H. Articles by Johan, R. Search for Related Content PubMed PubMed Citation Articles by Kjetil, H. Articles by Johan, R. Related Collections Pain Medicine Pain Pharmacology

---

ANALGESIA

The Prolonged Postoperative Analgesic Effect When Dexamethasone Is Added to a Nonsteroidal Antiinflammatory Drug (Rofecoxib) Before Breast Surgery

Hval Kjetil, MD^*, Thagaard K. Sem, MD^*, Schlichting Ellen, MD, PhD, and Raeder Johan, MD, PhD^*

From the Departments of *Anaesthesia and Surgery, Ullevaal University Hospital; and University of Oslo, Faculty Division, Ullevaal University Hospital, Oslo, Norway.

Address correspondence and reprint requests to Johan Raeder, Department of Anaesthesia, Ullevaal University Hospital, N-0407 Oslo, Norway. Address e-mail to johan.rader{at}medisin.uio.no.

Abstract

BACKGROUND: Glucocorticoids provide analgesia. In this study, we evaluated the effects of adding dexamethasone to a multimodal postoperative analgesic regimen, including a long-acting nonsteroidal antiinflammatory drug.

METHODS: One-hundred patients admitted for ambulatory breast cancer surgery were studied. They received paracetamol 2 g and rofecoxib 50 mg orally 1 h before start of general anesthesia with propofol and remifentanil. The patients were then randomized to receive, in a double-blind manner, either dexamethasone 16 mg IV or placebo. Both groups received fentanyl 1 µg/kg IV and 20–40 mL bupivacaine 2.5 mg/mL wound infiltration before the end of surgery.

RESULTS: There was no difference in pain scores or rescue medication between the groups during the first 4 h after surgery. After discharge, the median pain score during coughing or shoulder movement was 3 on a 0–10 scale in patients receiving placebo, and 1 in the patients receiving dexamethasone, which did not reach statistical significance (P = 0.06). From 24 to 72 h, the median pain with coughing or shoulder movement in patients receiving placebo was 2, and 1 in patients receiving dexamethasone, which did reach statistical significance (P < 0.05). Forty percent of patients receiving dexamethasone were pain free from 4 to 24 h, compared with 24% of patients receiving placebo, a difference that did not reach statistical significance (P = 0.09). Similarly, 46% of patients receiving dexamethasone were pain free from 24 to 72 h, compared with 28% of patients receiving placebo (P = 0.06). More patients had slept poorly on the first night in the dexamethasone group than in the control group, 68% vs 44%, (P < 0.05).

CONCLUSIONS: Dexamethasone 16 mg provides prolonged postoperative analgesia from 24 to 72 h after surgery when added to a multimodal regimen including nonsteroidal antiinflammatory drug (rofecoxib).

This article has been cited by other articles:

				O. Mathiesen, L. S. Jacobsen, H. E. Holm, S. Randall, L. Adamiec-Malmstroem, B. K. Graungaard, P. E. Holst, K. L. Hilsted, and J. B. Dahl Pregabalin and dexamethasone for postoperative pain control: a randomized controlled study in hip arthroplasty Br. J. Anaesth., October 1, 2008; 101(4): 535 - 541. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999