The effects of single‐dose dexamethasone on inflammatory response and pain after uterine artery embolisation for symptomatic fibroids or adenomyosis: a randomised controlled study

Objective To investigate the effects of single‐dose intravenous dexamethasone on inflammatory responses, pain, nausea, and vomiting after uterine artery embolisation (UAE). Design Prospective, randomised, double‐blind, and placebo‐controlled study. Setting Tertiary‐care University centre in Korea. P...

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Published in:BJOG : an international journal of obstetrics and gynaecology 2016-03, Vol.123 (4), p.580-587
Main Authors: Kim, SY, Koo, B‐N, Shin, CS, Ban, M, Han, K, Kim, MD
Format: Article
Language:English
Subjects:
Adenomyosis - epidemiology
Adenomyosis - therapy
Adult
Analgesics - administration & dosage
Anti-Inflammatory Agents - administration & dosage
Dexamethasone
Dexamethasone - administration & dosage
Embolisms
Female
Fibroids
Humans
Inflammation
Leiomyoma - epidemiology
Leiomyoma - therapy
Middle Aged
nausea
pain
Pain management
Pain Measurement
Pain, Postoperative - drug therapy
Postoperative Nausea and Vomiting - drug therapy
Prospective Studies
Republic of Korea - epidemiology
Studies
Treatment Outcome
uterine artery embolisation
Uterine Artery Embolization - adverse effects
Uterine Neoplasms - epidemiology
Uterine Neoplasms - therapy
vomiting
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Summary:Objective To investigate the effects of single‐dose intravenous dexamethasone on inflammatory responses, pain, nausea, and vomiting after uterine artery embolisation (UAE). Design Prospective, randomised, double‐blind, and placebo‐controlled study. Setting Tertiary‐care University centre in Korea. Population Patients undergoing UAE for the treatment of symptomatic fibroids or adenomyosis. Methods Patients were randomised to receive either intravenous dexamethasone (10 mg; dexamethasone group) or normal saline (control group) 1 hour before UAE. Both groups received fentanyl‐based intravenous patient‐controlled analgesia (PCA) during the 24 hours after UAE. Main outcome measures The primary outcomes were the inflammatory and stress responses measured by white blood cell count, neutrophil percentage, C–reactive protein (CRP), interleukin–6 (IL–6), and cortisol. Secondary outcomes were severity of pain and incidence of nausea and vomiting. Results Sixty‐four patients were enrolled and 59 patients completed the study. CRP, IL–6, and cortisol were significantly lower in the dexamethasone group compared with the control group during the 24 hours after UAE. Although the cumulative dose of fentanyl and additional analgesics administered during the 24 hours after UAE were similar between the two groups, pain scores were significantly lower in the dexamethasone group from 12 hours after UAE, and the incidence of severe nausea and vomiting was lower in the dexamethasone group. Conclusions The administration of single‐dose intravenous dexamethasone as an adjunct to fentanyl‐based intravenous PCA is effective in reducing inflammation and pain during the first 24 hours after UAE. Tweetable Dexamethasone is effective in reducing inflammation and pain after uterine artery embolisation. Tweetable Dexamethasone is effective in reducing inflammation and pain after uterine artery embolisation.
ISSN:1470-0328
1471-0528
DOI:10.1111/1471-0528.13785