Safety of perioperative dexamethasone administration in children: Time for reflection? [Innocuité de la dexaméthasone administrée en périopératoire chez l'enfant: est-il temps d'y repenser?]

摘要

The first reported human therapeutic use of cortisone occurred in 1948. The patient was a 29-yr-old woman being treated at the Mayo Clinic for severe rheumatoid arthritis. After 60 days of treatment, her rheumatoid symptoms had improved, but treatment was terminated due to side effects such as hirsutism, acne, and hostile ideation.1 Thus, it was notable that this first trial of therapeutic corticosteroid therapy was terminated due to complications from the drug. The purpose of this editorial is to review the current evidence for the safety profile of dexamethasone, a synthetic corticosteroid, given that the drug is now widely used in the perioperative period in both children and adults. Concerns may linger in the minds of some anesthesiologists that potential side effects from even a single modest dose of dexamethasone might be important.