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Background and aim <p>The immunosuppressive action of dexamethasone may help reduce the risk of postoperative complications such as infection, adhesion formation, and delayed wound healing. Dexamethasone may mitigate tissue damage and hasten recovery by attenuating the inflammatory response, modulating immune cell activity, and reducing the release of pro-inflammatory cytokines. In this first randomized trial of dexamethasone in robotic hysterectomy, we aimed to evaluate its effect on reducing C-reactive protein (CRP) as a proxy marker of surgical stress.</p> Methods <p>Women scheduled for robotic-assisted hysterectomy were recruited into a randomized trial comparing a preoperative dose of 24&#xa0;mg dexamethasone with placebo. Blood tests were obtained, and visual analogue scale scores for pain, postoperative nausea and vomiting, and medication use during admission were recorded at 0, 4, 8, 12, and 24&#xa0;h postoperatively.</p> Results <p>Among the 112 included women, postoperative CRP levels were lower in the dexamethasone group at 12 and 24&#xa0;h. Postoperative nausea and vomiting over time were also reduced in the dexamethasone group (<i>p</i> = 0.039 without adjustment; <i>p</i> = 0.02 with adjustment). Changes in CRP were analyzed using repeated-measures analysis, showing highly significant differences both without and with adjustment for BMI, age, and baseline CRP (both <i>p</i> &lt; 0.001). Overall, the dexamethasone group demonstrated substantially lower CRP levels during the postoperative period.</p> Conclusion <p>Dexamethasone significantly reduced postoperative CRP levels, suggesting a potential role in further reducing surgical stress in robotic-assisted hysterectomy.</p> Trial registration <p>European medical agency (EUDRACT no.2021-000874-28). 02.06.2021. CTIS Public Portal (European Medicines Agency)</p> <p>Registry of randomized clinical trials: NCT 04762381, “Effect of 24mg Dexamethasone Preoperatively on Surgical Stress, Pain and Recovery in Robotic-assisted Laparoscopic Hysterectomy”, 11th March 2022. ClinicalTrials.gov</p>

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The effect of dexamethasone on inflammatory markers of surgical stress: a randomized trial in robotic hysterectomy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月3日

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  • Karsten Kaiser,
  • Sven Hoedt Karstensen,
  • Sofie Ronja Petersen,
  • Kristian Als Nielsen,
  • Alexandros Valsamidis Valorenzos,
  • Thomas Strøm,
  • Ismail Gögenur,
  • Lukas Balsevicius,
  • Finn Friis Lauszus

摘要

Background and aim

The immunosuppressive action of dexamethasone may help reduce the risk of postoperative complications such as infection, adhesion formation, and delayed wound healing. Dexamethasone may mitigate tissue damage and hasten recovery by attenuating the inflammatory response, modulating immune cell activity, and reducing the release of pro-inflammatory cytokines. In this first randomized trial of dexamethasone in robotic hysterectomy, we aimed to evaluate its effect on reducing C-reactive protein (CRP) as a proxy marker of surgical stress.

Methods

Women scheduled for robotic-assisted hysterectomy were recruited into a randomized trial comparing a preoperative dose of 24 mg dexamethasone with placebo. Blood tests were obtained, and visual analogue scale scores for pain, postoperative nausea and vomiting, and medication use during admission were recorded at 0, 4, 8, 12, and 24 h postoperatively.

Results

Among the 112 included women, postoperative CRP levels were lower in the dexamethasone group at 12 and 24 h. Postoperative nausea and vomiting over time were also reduced in the dexamethasone group (p = 0.039 without adjustment; p = 0.02 with adjustment). Changes in CRP were analyzed using repeated-measures analysis, showing highly significant differences both without and with adjustment for BMI, age, and baseline CRP (both p < 0.001). Overall, the dexamethasone group demonstrated substantially lower CRP levels during the postoperative period.

Conclusion

Dexamethasone significantly reduced postoperative CRP levels, suggesting a potential role in further reducing surgical stress in robotic-assisted hysterectomy.

Trial registration

European medical agency (EUDRACT no.2021-000874-28). 02.06.2021. CTIS Public Portal (European Medicines Agency)

Registry of randomized clinical trials: NCT 04762381, “Effect of 24mg Dexamethasone Preoperatively on Surgical Stress, Pain and Recovery in Robotic-assisted Laparoscopic Hysterectomy”, 11th March 2022. ClinicalTrials.gov