Dexamethasone before total laparoscopic hysterectomy: a randomized controlled dose-response study

J Anesth. 2010 Feb;24(1):24-30. doi: 10.1007/s00540-009-0830-8. Epub 2010 Jan 6.


Purpose: A prospective, randomized, double blind, placebo-controlled study was undertaken to evaluate the efficacy of a single preoperative dose of dexamethasone, in different dosages, in providing postoperative analgesia in patients undergoing total laparoscopic hysterectomy (TLH).

Method: The study included 55 patients randomly divided into three groups. Patients in Groups P, D4, and D8 received saline, 4, and 8 mg dexamethasone, respectively, intravenously, 2 h before induction.

Results: The time to first analgesic requirement was significantly delayed in patients in the D8 group compared with the D4 group (P = 0.01) and placebo (P = 0.01). Total postoperative fentanyl consumption was significantly less in patients in the D8 group compared with the D4 group (P = 0.01) and placebo (P = 0.01). Use of 8 mg dexamethasone resulted in a 99.3 mcg decrease in total 24-h fentanyl consumption. Postoperative nausea and vomiting (PONV) was significantly less in the D8 group with a complete response rate (no emetic episodes and no rescue medication for 24 h) of 36.8% compared with the placebo group in which all the patients had PONV. No adverse effects were observed in any group.

Conclusion: Dexamethasone at a dose of 8 mg given intravenously 2 h before induction, delays patient request for analgesia and reduces total fentanyl consumption and PONV in patients undergoing TLH.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analgesia / methods*
  • Analgesia, Patient-Controlled
  • Analgesics / administration & dosage*
  • Analgesics / adverse effects
  • Analgesics / therapeutic use
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / adverse effects
  • Dexamethasone / administration & dosage*
  • Dexamethasone / adverse effects
  • Dexamethasone / therapeutic use
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Drug Therapy, Combination
  • Female
  • Fentanyl / administration & dosage
  • Fentanyl / adverse effects
  • Humans
  • Hysterectomy*
  • Laparoscopy
  • Middle Aged
  • Pain Measurement
  • Pain, Postoperative / drug therapy*
  • Postoperative Nausea and Vomiting / prevention & control
  • Preanesthetic Medication
  • Time Factors


  • Analgesics
  • Analgesics, Opioid
  • Dexamethasone
  • Fentanyl