title: The effect of single low-dose dexamethasone on blood glucose concentrations in the perioperative period: a randomized, placebo-controlled investigation in gynecologic surgical patients.
abstract: BACKGROUND
  The effect of single low-dose dexamethasone therapy on perioperative blood glucose concentrations has not been well characterized. In this investigation, we examined the effect of 2 commonly used doses of dexamethasone (4 and 8 mg at induction of anesthesia) on blood glucose concentrations during the first 24 hours after administration.
  
  
  METHODS
  Two hundred women patients were randomized to 1 of 6 groups: Early-control (saline); Early-4 mg (4 mg dexamethasone); Early-8 mg (8 mg dexamethasone); Late-control (saline); Late-4 mg (4 mg dexamethasone); and Late-8 mg (8 mg dexamethasone). Blood glucose concentrations were measured at baseline and 1, 2, 3, and 4 hours after administration in the early groups and at baseline and 8 and 24 hours after administration in the late groups. The incidence of hyperglycemic events (the number of patients with at least 1 blood glucose concentration >180 mg/dL) was determined.
  
  
  RESULTS
  Blood glucose concentrations increased significantly over time in all control and dexamethasone groups (from median baselines of 94 to 102 mg/dL to maximum medians ranging from 141 to 161.5 mg/dL, all P < 0.001). Blood glucose concentrations did not differ significantly between the groups receiving dexamethasone (either 4 or 8 mg) and those receiving saline at any measurement time. The incidence of hyperglycemic events did not differ in any of the early (21%-28%, P = 0.807) or late (13%-24%, P = 0.552) groups.
  
  
  CONCLUSIONS
  Because blood glucose concentrations during the first 24 hours after administration of single low-dose dexamethasone did not differ from those observed after saline administrations, these results suggest clinicians need not avoid using dexamethasone for nausea and vomiting prophylaxis out of concerns related to hyperglycemia.
authors.affiliation: From the *Department of Anesthesiology, NorthShore University HealthSystem, Evanston; and †Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Glenn S
authors.initials: GS
authors.lastname: Murphy
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Szokol
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Avram
authors.forename: Steven B
authors.initials: SB
authors.lastname: Greenberg
authors.forename: Torin
authors.initials: T
authors.lastname: Shear
authors.forename: Jeffery S
authors.initials: JS
authors.lastname: Vender
authors.forename: Jayla
authors.initials: J
authors.lastname: Gray
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Landry
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D000932:Antiemetics / Q000009:adverse effects* / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism*; D003907:Dexamethasone / Q000009:adverse effects* / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control; D008875:Middle Aged; D059035:Perioperative Period; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control
chemical_list: D000932:Antiemetics; D001786:Blood Glucose; D003907:Dexamethasone