title: Effects of dexamethasone and pheniramine hydrogen maleate on stress response in patients undergoing elective laparoscopic cholecystectomy.
abstract: BACKGROUND
  Laparoscopic cholecystectomy (LC) still leads to significant postoperative nausea and vomiting (PONV) and pain. Our aim was to evaluate the efficacy of dexamethasone or pheniramine hydrogen maleate, either alone or combined, in reducing the stress response and symptoms after LC.
  
  
  METHODS
  Patients were randomly assigned to 1 of 4 groups, each consisting of 20 patients: control, dexamethasone (8 mg/2 mL), pheniramine hydrogen maleate (45.5 mg/2 mL), and the combined group. The drugs were given before anesthesia induction.
  
  
  RESULTS
  C-reactive protein levels (CRP) and visual analog scale (VAS) scores were significantly less in the dexamethasone (P = .003) and combined groups (P < .001). Both dexamethasone (P < .001) and pheniramine hydrogen maleate (P = .005) significantly reduced PONV.
  
  
  CONCLUSIONS
  Dexamethasone significantly reduced postoperative pain and the systemic acute-phase response, whereas these effects were only partially attained with pheniramine hydrogen maleate. Both dexamethasone and pheniramine hydrogen maleate significantly reduced PONV. An additive effect seemed to occur if these drugs were used in combination.
authors.affiliation: Department of Gastroenterological Surgery, Turkiye Yuksek Ihtisas Teaching and Research Hospital, Ankara, Turkey. keremkaraman1972@yahoo.com
authors.forename: Kerem
authors.initials: K
authors.lastname: Karaman
authors.forename: Erdal Birol
authors.initials: EB
authors.lastname: Bostanci
authors.forename: Erol
authors.initials: E
authors.lastname: Aksoy
authors.forename: Murat
authors.initials: M
authors.lastname: Ulas
authors.forename: Tuba
authors.initials: T
authors.lastname: Yigit
authors.forename: Mehmet Ozcan
authors.initials: MO
authors.lastname: Erdemli
authors.forename: Ugur
authors.initials: U
authors.lastname: Ercin
authors.forename: Ayse
authors.initials: A
authors.lastname: Bilgihan
authors.forename: Gul
authors.initials: G
authors.lastname: Saydam
authors.forename: Musa
authors.initials: M
authors.lastname: Akoglu
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D000932:Antiemetics / Q000008:administration & dosage / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000378:metabolism; D017081:Cholecystectomy, Laparoscopic; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D017558:Elective Surgical Procedures; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D010632:Pheniramine / Q000008:administration & dosage / Q000627:therapeutic use*; D020250:Postoperative Nausea and Vomiting / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D013312:Stress, Physiological / Q000187:drug effects*; D016896:Treatment Outcome; D014421:Turkey
chemical_list: D000700:Analgesics; D000932:Antiemetics; D010632:Pheniramine; D003907:Dexamethasone; D002097:C-Reactive Protein