The purpose of this study review was to clarify the most appropriate preoperative dose of dexamethasone for diabetic patients.
Diabetes is a disease with a high incidence on the island, as 16% of the Puerto Rican population suffers from it. Photo: Shutterstock.com.
A review study conducted between Puerto Rico and universities in the United States states that evidence suggests that diabetic patients who receive dexamethasone in the perioperative period are more likely to develop hyperglycemia, including a drop in blood sugar. The maximum increase is 30 to 45 mg/dL. The first 24 hours after a single dose.
Its purpose suggests that perioperative administration of a single dose of dexamethasone in this population of patients helps reduce postoperative nausea, vomiting, bloating, and pain.
However, he says it is not clear which dosage elicits these effects while reducing the hyperglycemic effect in patients. diabetes,
Precisely, the team decided to conduct studies to clarify the most appropriate perioperative dose of dexamethasone for patients with diabetes and if necessary to suspend it in patients with poor glycemic control.
The methodology included a bibliographic search using PubMed and the Cochrane Database of Systematic Reviews, which revealed 17 possible sources of evidence. Some eight sources met the inclusion criteria. The sources included one systematic review with meta-analysis, one randomized controlled trial, and six observational studies.
One study described higher blood sugar levels with increasing dosage, but no other sources supported this finding. The available studies were markedly heterogeneous in both the design and proportion of included diabetic subjects, and most were of low quality.
Although the study has its own recommendations on the use of this drug, it also emphasizes that there is insufficient evidence to measure the hyperglycemic effect of commonly used doses of dexamethasone, and that rigorous studies are needed.
The literature says that dexamethasone plays an important role in controlling postoperative nausea and vomiting, as it has shown great efficacy; However, its use in patients with diabetes is cautious, and anesthesiologists have avoided its use because of the increase in plasma glucose.
Dexamethasone is a steroid drug that controls the inflammatory process, as it reappeared during the advent of the COVID-19 pandemic.
diabetes It is a disease with a high incidence on the island, as 16% of the Puerto Rican population suffers from it, according to endocrinologists in the country.
View the study published by the Journal of Perianesthesia Nursing ASPAN here.