Blood glucose was higher after surgery than before, and it made no difference if placebo or dexamethasone was used when controlling for PONV. (Image source: Thinkstock)

Blood glucose was higher after surgery than before, and it made no difference if placebo or dexamethasone was used when controlling for PONV. (Image source: Thinkstock)

Dexamethasone is used to control postoperative nausea and vomiting (PONV).  Steroid-induced hyperglycemia can be problematic, though hyperglycemia is usually seen after patients are given higher doses of steroids than are used to control PONV.  When dexamethasone specifically is used to control PONV, is it accompanied by hyperglycemia?

Dr. Glenn S. Murphy, Department of Anesthesia, NorthShore University HealthSystem, Evanston, IL and colleagues gave almost 200 patients 4 or 8 mg of dexamethasone or placebo and measured blood glucose postoperatively.  Their results are presented in the article “The Effect of Single Low-Dose Dexamethasone on Blood Glucose Concentrations in the Perioperative Period: A Randomized, Placebo-Controlled Investigation in Gynecologic Surgical Patients,” which is published in the June 2014 issue of Anesthesia & Analgesia.

To limit the number of finger sticks, in some patients blood glucose was measured in the first four hours after dexamethasone administration, and in others, blood glucose was measured 8-24 hours after drug injection.  Dexamethasone was administered during induction of anesthesia.  Sevoflurane was the primary drug used for maintenance of anesthesia.

On average, blood glucose was higher after surgery than before. There was no difference in blood glucose between patients receiving dexamethasone and patients receiving placebo.

Diabetic patients were excluded from this study and it is unclear if the same results would be found had these patients been included.  Unexpectedly, PONV rates were no different between placebo and both dexamethasone groups.  In one of the groups of patients who received dexamethasone (the Early-4 mg group), the number of patients who needed pain medication was less compared to the other study groups.