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

الملخص EN

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.