Wound complications with dexamethasone for postoperative nausea and vomiting prophylaxis: A moot point?

摘要

Dexamethasone and 5-hydroxytryptamine-3 receptor antagonists are probably the most frequently used drugs for postoperative nausea and vomiting (PONV) prophylaxis in modern anesthetic practice. The number needed to treat to prevent PONV for ondansetron has been found to be 6 to 7, whereas that for dexamethasone is 4. With better efficacy, the relatively low cost of dexamethasone renders it a more desirable option, except for the potential side effects that can be associated with steroid use. In this issue of Anesthesia & Analgesia, Bolac et al. present a single-center, retrospective observational study that attempts to assess the effect of an intraoperative single dose of IV dexamethasone (4-12 mg) on postoperative wound complications in 431 female patients undergoing gyne-oncological surgery for endometrial cancer. The primary outcome was a composite of postoperative wound complications (surgical site infection, wound cellulitis, wound separation and fascial dehiscence). The authors also reported other outcomes, such as time to complete wound healing in patients who had wound complications. The results of the study suggest that there is no statistically significant increase in the incidence of wound complications or time to complete wound healing in patients who received dexamethasone for PONV prophylaxis.