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Year : 2015  |  Volume : 29  |  Issue : 2  |  Page : 100-105

The preoperative single dose dexamethasone effect to pro-and anti-inflammatory cytokine during orthopedic surgery

1 Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Hasanuddin University, Makassar, Sulawesi Selatan, Indonesia
2 Department of Physiology, Faculty of Medicine, Hasanuddin University, Makassar, Sulawesi Selatan, Indonesia

Correspondence Address:
A M Takdir Musba
Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Hasanuddin University, Makassar
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0970-5333.155179

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Background: The efficacy of glucocorticoids like dexamethasone in reducing postoperative pain has been investigated and showed that a single dose of dexamethasone significantly analgesia has advantages in terms of reduction in pain intensity, opioid requirements, rescue analgesia, and did not increase the incidence of infection and impaired wound healing. The aim of this study was to evaluate the effects of preoperative single dose of intravenous dexamethasone to the dynamics of pro- and anti-inflammatory cytokine in orthopedic surgery perioperative period. Materials and Methods: Thirty patients were studied and randomly into two groups: 15 patients received 8 mg dexamethasone intravenous preoperatively and perioperative analgesia with paracetamol and patient-controlled analgesia (PCA) morphine (dexamethasone group) and 15 patients received perioperative analgesia paracetamol and PCA morphine only (control group). Blood samples were taken at the time before anesthesia, immediately postsurgery, 4 h and 24 h after surgery to measure plasma levels of interleukin 6 (IL-6) and IL-10. We recorded the pain intensity and morphine requirement in 4 h and 24 h after surgery. Results: IL-6 levels in the dexamethasone group did not increased from immediately after surgery to 24 h after surgery but increased in the control group (P < 0.05). There is no difference of IL-10 levels in both groups at all measurement time. Rest and moving pain intensity from time to time in the two groups did not differ except the rest pain at 24 h postoperative (P < 0.05). Morphine requirement in the dexamethasone group was lower in the 24 h after surgery than the control group. Conclusion: The addition of dexamethasone preoperatively on the combination of paracetamol and morphine did not change plasma levels of IL-6 and IL-10 cytokines Dexamethasone provides sufficient analgesia and decrease postoperative opioid requirement.

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