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

Authors
 SY Kim  ;  B-N Koo  ;  CS Shin  ;  M Ban  ;  K Han  ;  MD Kim 
Citation
 BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Vol.123(4) : 580-587, 2016 
Journal Title
 BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY 
ISSN
 1470-0328 
Issue Date
2016
MeSH
Adenomyosis/epidemiology ; Adenomyosis/therapy* ; Adult ; Analgesics/administration & dosage* ; Anti-Inflammatory Agents/administration & dosage* ; Dexamethasone/administration & dosage* ; Female ; Humans ; Leiomyoma/epidemiology ; Leiomyoma/therapy* ; Middle Aged ; Pain Measurement ; Pain, Postoperative/drug therapy* ; Postoperative Nausea and Vomiting/drug therapy* ; Prospective Studies ; Republic of Korea/epidemiology ; Treatment Outcome ; Uterine Artery Embolization/adverse effects* ; Uterine Neoplasms/epidemiology ; Uterine Neoplasms/therapy*
Keywords
Dexamethasone ; inflammation ; nausea ; pain ; uterine artery embolisation ; vomiting
Abstract
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 ABSTRACT: Dexamethasone is effective in reducing inflammation and pain after uterine artery embolisation.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.13785/abstract
DOI
10.1111/1471-0528.13785
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Bon-Nyeo(구본녀) ORCID logo https://orcid.org/0000-0002-3189-1673
Kim, Man Deuk(김만득) ORCID logo https://orcid.org/0000-0002-3575-5847
Kim, So Yeon(김소연) ORCID logo https://orcid.org/0000-0001-5352-157X
Ban, Min Gi(반민지) ORCID logo https://orcid.org/0000-0002-1116-9472
Shin, Cheung Soo(신증수) ORCID logo https://orcid.org/0000-0001-7829-8458
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146570
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