title: A Single Perioperative Injection of Dexamethasone Decreases Nausea, Vomiting, and Pain after Laparoscopic Donor Nephrectomy.
abstract: Background.A single dose of perioperative dexamethasone (8-10 mg) reportedly decreases postoperative nausea, vomiting, and pain but has not been widely used in laparoscopic donor nephrectomy (LDN).Methods.We performed a retrospective cohort study of living donors who underwent LDN between 2013 and 2015. Donors who received a lower dose (4-6 mg)  (n= 70) or a higher dose (8-14 mg) of dexamethasone (n= 100) were compared with 111 donors who did not receive dexamethasone (control). Outcomes and incidence of postoperative nausea, vomiting, and pain within 24 h after LDN were compared before and after propensity-score matching.Results. The higher dose of dexamethasone reduced postoperative nausea and vomiting incidences by 28% (P= 0.010) compared to control, but the lower dose did not. Total opioid use was 29% lower in donors who received the higher dose than in control (P= 0.004). The higher dose was identified as an independent factor for preventing postoperative nausea and vomiting. Postoperative complication rates and hospital stays did not differ between the groups. After propensity-score matching, the results were the same as for the unmatched analysis.Conclusion.A single perioperative injection of 8-14 mg dexamethasone decreases antiemetic and narcotic requirements in the first 24 h, with no increase in surgical complications.
authors.affiliation: Division of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA, USA; Department of General Surgery, Japanese Red Cross Kumamoto Hospital, Kumamoto, Kumamoto, Japan; Department of Renal Transplant Surgery, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan.
authors.forename: Shigeyoshi
authors.initials: S
authors.lastname: Yamanaga
authors.affiliation: Division of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Andrew Mark
authors.initials: AM
authors.lastname: Posselt
authors.affiliation: Division of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Chris Earl
authors.initials: CE
authors.lastname: Freise
authors.affiliation: Department of Renal Transplant Surgery, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Division of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Tavakol
authors.affiliation: Division of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Sang-Mo
authors.identifier: 0000-0002-9064-0006
authors.initials: SM
authors.lastname: Kang