The effect of preoperative high dose methylprednisolone in attenuating the metabolic response after oesophageal resection.
OBJECTIVE
To evaluate the effect of giving glucocorticoids preoperatively for the prophylaxis of surgical stress.


METHODS
Prospective randomised study.


METHODS
University hospital, Japan.


METHODS
30 patients undergoing resection of oesophageal carcinoma.


METHODS
15 patients (group 1) were randomised to be given methylprednisolone (30 mg/kg) and 15 patients (group 2) to be given saline intravenously before operation.


METHODS
Outcome, length of stay in the intensive care unit (ICU), metabolic response, and oxygenation.


RESULTS
Patients given methylprednisolone had a mean stay in the ICU of 5.1 +/- 1.0 days compared with 8.2 +/- 4.5 days in the saline group (p < 0.01). 5 patients in the saline group compared with 0 in the methylprednisolone group developed postoperative complications (p = 0.02). Plasma norepinephrine and arginine vasopressin levels in methylprednisolone group were significantly lower than those in the saline group (p < 0.05). The PaO2:FiO2 ratio in the saline group was significantly lower than that in the experimental group (p < 0.01).


CONCLUSIONS
Preoperative methylprednisolone may facilitate the postoperative management of surgical patients.
Takeda
S
S
Department of Intensive Care Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan.
Ogawa
R
R
Nakanishi
K
K
Kim
C
C
Miyashita
M
M
Sasajima
K
K
Onda
M
M
Takano
T
T
D000328:Adult; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004305:Dose-Response Relationship, Drug; D004734:Energy Metabolism / Q000502:physiology; D004938:Esophageal Neoplasms / Q000601:surgery*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D011184:Postoperative Period; D011292:Premedication; D011446:Prospective Studies; D013315:Stress, Psychological / Q000517:prevention & control*
D005938:Glucocorticoids; D008775:Methylprednisolone