The effect of dexamethasone on quality of recovery and analgesic consumption after valvular cardiac surgery

Abstract

Background Many therapeutic strategies have been developed to attenuate the inflammatory reaction to cardiopulmonary bypass and thereby enhance fast-track recovery of the cardiac surgical patient. The aim of the study was to determine the effect of small versus intermediate dose of dexamethasone on patient-perceived quality-of-recovery (QoR) scores in valvular replacement cardiac surgical patients and postoperative analgesic consumption. Patients and methods After obtaining local ethics committee approval and wr tten consent, 60 patients with American Society of Anesthesiologists physical state II and III, aged 16–60 years underwent elective valvular replacement surgery. Those patients were randomly divided into three equal groups, with 20 patients each. Group S received small-dose dexamethasone (0.1 mg/kg) in a total volume of 5-ml saline, group I received intermediate-dose dexamethasone (0.2 mg/kg), and group C received placebo (5-ml saline). Results Our results concerned with QoR-40 score showed significant statistical difference between the three groups in the dimensions of emotions, physical comfort, psychological support, and pain but not in the dimension of physical independence, in favor of dexamethasone groups. Conclusion Postoperative QoR-40 scores in the dimensions of emotional state, physical comfort, psychological support, and pain were all improved in the dexamethasone groups compared with the control group. The intermediate dose (0.2 mg/kg) of dexamethasone was better than the small dose (0.1 mg/kg) in the dimension of pain on postoperative day (POD) 1 and POD 2, whereas it was better on POD 3 and POD 2 in the dimensions of psychological support and physical comfort, respectively.