title: Analgesic effect of preoperative versus intraoperative dexamethasone after laparoscopic cholecystectomy with multimodal analgesia.
abstract: BACKGROUND
  Pain after laparoscopy is multifactorial and different treatments have been proposed to provide pain relief. Multimodal analgesia is now recommended to prevent and treat post-laparoscopy pain. Dexamethasone is effective in reducing postoperative pain. The timing of steroid administration seems to be important. We evaluated the analgesic efficacy of preoperative intravenous dexamethasone 1 hour before versus during laparoscopic cholecystectomy with multimodal analgesia.
  
  
  METHODS
  One hundred twenty patients aged 20 to 65 years old were allocated randomly into one of three groups (n = 40, in each). The patients in the group N received normal saline 1 hour before induction and after the resection of gall bladder. The patients in the group S1 received dexamethasone 8 mg 1 hour before induction and normal saline after the resection of gall bladder. The patients in the group S2 received normal saline 1 hour before induction and dexamethasone 8 mg after the resection of gall bladder.
  
  
  RESULTS
  VAS scores of group S1 and S2 were lower than that of group N during 48 hours after laparoscopic cholecystectomy. There were no significant differences of VAS scores between the group S1 and the group S2. The analgesic consumption of group S1 and S2 were significantly lower than that of group N.
  
  
  CONCLUSIONS
  A single dose of dexamethasone (8 mg) intravenously given 1 hour before induction or during operation was effective in reducing postoperative pain after laparoscopic cholecystectomy with multimodal analgesia. The analgesic efficacy of preoperative intravenous dexamethasone 1 hour before versus during surgery was not significantly different.
authors: Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea.
authors: Se Hun
authors: SH
authors: Lim
authors: Eun Ho
authors: EH
authors: Jang
authors: Myoung-Hun
authors: MH
authors: Kim
authors: Kwangrae
authors: K
authors: Cho
authors: Jeong Han
authors: JH
authors: Lee
authors: Kun Moo
authors: KM
authors: Lee
authors: Soon Ho
authors: SH
authors: Cheong
authors: Young-Jae
authors: YJ
authors: Kim
authors: Chee-Mahn
authors: CM
authors: Shin