복강경 담낭절제술에서 연령과 성별이 고려될 때 수술 전 Dexamethasone의 투여가 수술 후 통증에 미치는 영향
The Effect of Preoperative Dexamethasone Administration, according to Age and Gender on Postoperative Pain in Patients who Undergo Laparoscopic Choelecystectomy
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Background: Preoperative dexamethasone improves the surgical outcome after laparoscopic cholecystectomy (LC). The purpose of this study was to determine the effect of preoperative dexamethasone on the postoperative pain according to age and gender in patients who undergo LC. Methods: In this double blind prospective study, 400 patients, males or females ≤ 45 yr and males or females ≥ 65 yr (n = 50 in each of eight groups) who undergoing LC were randomized to receive dexamethasone 8 mg (5 ml) or saline 5 ml intravenously 100 minutes before their operation. Postoperative pain was assessed on a visual analog scale (VAS) at 1, 6, 12, and 24 hour, and the time to administering the first postoperative analgesics was recorded. Results: Dexamethasone was administered without consideration for age and gender, and it reduced the postoperative pain VAS score at 1, 6, and 12 hours, and the opioid analgesic requirement, but there was no significant difference between administering saline or dexamethasone in the same gender and age groups. Females ≤ 45 yr who were administered saline had the most pain sensitivity and males ≥ 65 yr who were administered dexamethasone had the least pain sensitivity. Conclusions: Preoperative dexamethasone reduces the pain intensity and opioid consumption, but does not reduce the pain intensity, according to age and gender in the patients undergoing LC. As a result, preoperative dexamethasone should be considered for routine use for patients who are undergoing laparoscopic cholecystectomy. (Korean J Pain 2008; 21: 51−56)
Abstract
Background: Preoperative dexamethasone improves the surgical outcome after laparoscopic cholecystectomy (LC). The purpose of this study was to determine the effect of preoperative dexamethasone on the postoperative pain according to age and gender in patients who undergo LC. Methods: In this double blind prospective study, 400 patients, males or females ≤ 45 yr and males or females ≥ 65 yr (n = 50 in each of eight groups) who undergoing LC were randomized to receive dexamethasone 8 mg (5 ml) or saline 5 ml intravenously 100 minutes before their operation. Postoperative pain was assessed on a visual analog scale (VAS) at 1, 6, 12, and 24 hour, and the time to administering the first postoperative analgesics was recorded. Results: Dexamethasone was administered without consideration for age and gender, and it reduced the postoperative pain VAS score at 1, 6, and 12 hours, and the opioid analgesic requirement, but there was no significant difference between administering saline or dexamethasone in the same gender and age groups. Females ≤ 45 yr who were administered saline had the most pain sensitivity and males ≥ 65 yr who were administered dexamethasone had the least pain sensitivity. Conclusions: Preoperative dexamethasone reduces the pain intensity and opioid consumption, but does not reduce the pain intensity, according to age and gender in the patients undergoing LC. As a result, preoperative dexamethasone should be considered for routine use for patients who are undergoing laparoscopic cholecystectomy. (Korean J Pain 2008; 21: 51−56)
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