title: Preoperative High Dose of Methylprednisolone Improves Early Postoperative Pulmonary Function, in Super-Obese Patients Undergoing Open Surgery; a Prospective, Comparative Study.
abstract: Surgery stimulates an intense systemic inflammatory response which might increase postoperative morbidity. Corticosteroids may reduce this inflammatory reaction. The purpose of this study was to investigate any possible effect on postoperative morbidity and recovery after administrating methylprednisolone in super-obese patients undergoing open surgery.
  
  
  
  Sixty super-obese patients with BMI ≥50 kg/m2(mean 57.48 ± 7.33), mean age of 39 ± 9 years, who underwent an open bariatric procedure, were enrolled. Thirty patients (group A) were allocated to a preoperative single dose of 30 mg/kg (ideal body weight) methylprednisolone versus placebo (group B, 30 patients). Endpoints included assessment of IL-6 and CRP; evaluation of postoperative pulmonary function, pain management, nausea, and vomiting; and documentation of postoperative complications.
  
  
  
  Significant improvement in spirometry parameters and arterial blood gas analysis, in the first and third postoperative days, was observed in the methylprednisolone group. IL-6 and CRP levels were significantly lower in that group. Administration of methylprednisolone was associated with less postoperative pain, nausea, and vomiting, with no statistical difference in septic complications.
  
  
  
  Preoperative administration of a single high dose of methylprednisolone in super-obese patients undergoing open surgery inhibits the inflammatory signaling cascade, lessens the systemic inflammatory response, and results in fewer pulmonary complications and better patient recovery.
authors.affiliation: Morbid Obesity Unit, Department of Surgery, University Hospital of Patras, Rion Patras, 26504, Patras, Greece. skroubis@med.upatras.gr.
authors.forename: George
authors.identifier: 0000-0003-2392-2078
authors.initials: G
authors.lastname: Skroubis
authors.affiliation: Morbid Obesity Unit, Department of Surgery, University Hospital of Patras, Rion Patras, 26504, Patras, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Theofanis
authors.affiliation: Morbid Obesity Unit, Department of Surgery, University Hospital of Patras, Rion Patras, 26504, Patras, Greece.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Spyropoulos
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, University Hospital of Patras, Patras, Greece.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Zotou
authors.affiliation: University Hospital of Patras, Patras, Greece.
authors.forename: Petros
authors.initials: P
authors.lastname: Constantinopoulos
authors.affiliation: Morbid Obesity Unit, Department of Surgery, University Hospital of Patras, Rion Patras, 26504, Patras, Greece.
authors.forename: Fotis
authors.initials: F
authors.lastname: Kalfarentzos
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece.
authors.forename: Theodore
authors.initials: T
authors.lastname: Alexandrides
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D009325:Nausea / Q000517:prevention & control; D009767:Obesity, Morbid / Q000601:surgery*; D010149:Postoperative Pain / Q000517:prevention & control; D011183:Postoperative Complications / Q000503:physiopathology / Q000517:prevention & control*; D011184:Postoperative Period; D011446:Prospective Studies; D013147:Spirometry; D018746:Systemic Inflammatory Response Syndrome / Q000503:physiopathology / Q000517:prevention & control*; D014839:Vomiting / Q000517:prevention & control
chemical_list: D000893:Anti-Inflammatory Agents; D015850:Interleukin-6; D002097:C-Reactive Protein; D008775:Methylprednisolone
keywords: Bariatric surgery; Inflammatory response; Laparotomy; Methylprednisolone; Morbid obesity; Morbidity