The effect of dilution and prolonged injection time on dexamethasone-induced perineal pruritus.
Dexamethasone has been widely used before general anesthesia induction. However, previous studies have found that a pre-induction bolus dose of dexamethasone sometimes causes perineal pruritus. We hypothesized that an appropriate prolongation of the injection time might suppress dexamethasone-induced perineal pruritus. Four hundred patients requiring general anaesthesia were randomly allocated into four groups: group I receiving 2 ml dexamethasone (5 mg/ml); group II receiving 4 ml dexamethasone (2.5mg/ml); group III receiving 10 ml dexamethasone (1 mg/ml); and group IV receiving 20 ml dexamethasone (0.5 mg/ml). Dexamethasone was diluted with 0.9% sodium chloride. The injection time of dexamethasone was 5s in groups I, II and III; while the injection time of dexamethasone was 30s in group IV. Occurrence of perineal pruritus was significantly reduced in Group IV (0% vs 38%, 32% and 12% in Groups I, II and III, respectively, p < 0.05). The incidence was higher in females than in males (p < 0.05). The duration of perineal pruritus was longer in females than in males in groups I, II and III (p < 0.05). We conclude that the dilution of dexamethasone to 0.5 mg/ml with 0.9% sodium chloride combined with prolonged injection time to 30 s eliminates dexamethasone-induced perineal pruritus.
Department of Anesthesiology, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China.
C Y
CY
Gu
Y M
YM
Wu
M T
MT
Zhou
F
F
Li
Q F
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Tang
D000328:Adult; D000368:Aged; D000758:Anesthesia; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D003907:Dexamethasone / Q000008:administration & dosage* / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010502:Perineum; D019999:Pharmaceutical Solutions; D011537:Pruritus / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control*; D012727:Sex Characteristics; D055815:Young Adult
D000893:Anti-Inflammatory Agents; D019999:Pharmaceutical Solutions; D003907:Dexamethasone