Pre-Induction Dexamethasone Does Not Decrease Complications after Microvascular Decompression for Facial Spasm

Abstract

Background: Postoperative pain, sore throat, hoarseness, early facial paralysis and pyrexia are common complications after microvascular decompression (MVD) for facial spasm. Dexamethasone (Dex) is used extensively in the perioperative setting as it is a high-potency, long-acting glucocorticoid with little mineralocorticoid effects. It may improve analgesia and decrease opioid consumption, significantly decrease the incidence and severity of sore throat and hoarseness after general anesthesia, and antagonize the inflammatory reaction in the postoperative period. We designed this study to determine the effects of Dex on these complications.Methods: A total of 1020 adult patients with hemifacial spasm who were scheduled to receive MVD, were randomly divided into three groups: Dex-0 (N=340), Dex-1 (N=340) and Dex-2 (N=340), respectively, and were administered normal sodium, Dex 0.1 mg/kg or 0.2 mg/kg before induction of anesthesia. Incision pain, sore throat and hoarseness, early facial paralysis, and pyrexia were evaluated. Postoperative incision pain was recorded during the first and second day after surgery; sore throat and hoarseness, early facial paralysis, and pyrexia were recorded from the day after surgery and until the end of the fifth day after surgery.Results: One thousand and fifteen patients completed this clinical trail. Within the 3 groups: Dex-0 group (N=337), Dex-1 group (N=339) and Dex-2 group (N=339), we found no significant differences concerning postoperative incision pain, sore throat, hoarse, early facial paralysis and the intensity of pyrexia (P>0.05).Conclusions: Administration of Dex (0.1 mg/kg or 0.2 mg/kg) before anesthesia induction did not limit adverse outcomes after MVD. Citation: Qi-Wu Fang, Xiao-Yan Qian, Jian-Xiong An, Hui Wen, Jian-Ping Wu, Doris K. Cope, et al. Pre-induction dexamethasone does not decrease complications after microvascular decompression for facial spasm. J Anesth Perioper Med 2015; 2: 192-6. doi: 10.24015/JAPM.2015.0026This is an open-access article, published by Evidence Based Communications (EBC). This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium or format for any lawful purpose. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.