Effects of single dose, postinduction dexamethasone on recovery after cardiac surgery

Ann Thorac Surg. 2000 May;69(5):1420-4. doi: 10.1016/s0003-4975(00)01180-2.


Background: Corticosteroids have been recommended to facilitate rapid recovery after cardiac surgery. We previously reported that dexamethasone given after induction of anesthesia decreases the incidence of postoperative shivering. We performed a post hoc analysis of the data obtained during that study, focusing on secondary outcomes.

Methods: A total of 235 adult patients undergoing elective coronary or valvular heart surgery were randomized to receive dexamethasone 0.6 mg/kg or placebo after induction of anesthesia. Patients who had pharmacologically treated diabetes mellitus, had hypersensitivity to dexamethasone, or were receiving treatment with corticosteroids were excluded.

Results: We found that, compared with placebo, patients receiving dexamethasone were more likely to remain tracheally intubated for 6 hours or less (26.4% vs 10.0%, p = 0.020) and had a lower incidence of early postoperative fever (20.2% vs 36.8%, p = 0.009) and new-onset atrial fibrillation during the first 3 days postoperatively (18.9% vs 32.3%, p = 0.027). However, we could not demonstrate a statistical difference in the intensive care unit or hospital length of stay, or in overall morbidity and mortality. The dexamethasone-treated patients were also more likely to have a higher blood glucose on admission to the intensive care unit (186 mg/dL vs 143 mg/dL, p = 0.012).

Conclusions: Dexamethasone facilitates early tracheal extubation and is associated with a lower incidence of early postoperative fever and new-onset atrial fibrillation. Apart from a treatable decreased glucose tolerance, dexamethasone treatment was not shown to affect morbidity or mortality significantly.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Anesthesia
  • Anti-Inflammatory Agents / administration & dosage*
  • Atrial Fibrillation / prevention & control
  • Blood Glucose / analysis
  • Cardiac Surgical Procedures*
  • Dexamethasone / administration & dosage*
  • Elective Surgical Procedures
  • Female
  • Humans
  • Intensive Care Units
  • Intubation, Intratracheal
  • Length of Stay
  • Male
  • Middle Aged
  • Postoperative Complications / prevention & control
  • Treatment Outcome


  • Anti-Inflammatory Agents
  • Blood Glucose
  • Dexamethasone