George Skroubis1, George Theofanis2, Charalampos Spyropoulos2, Anastasia Zotou3, Petros Constantinopoulos4, Fotis Kalfarentzos2, Theodore Alexandrides5. 1. Morbid Obesity Unit, Department of Surgery, University Hospital of Patras, Rion Patras, 26504, Patras, Greece. skroubis@med.upatras.gr. 2. Morbid Obesity Unit, Department of Surgery, University Hospital of Patras, Rion Patras, 26504, Patras, Greece. 3. Department of Anesthesiology and Critical Care Medicine, University Hospital of Patras, Patras, Greece. 4. University Hospital of Patras, Patras, Greece. 5. Division of Endocrinology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece.
Abstract
BACKGROUND: Surgery stimulates an intense systemic inflammatory response which might increase postoperative morbidity. Corticosteroids may reduce this inflammatory reaction. The purpose of this study was to investigate any possible effect on postoperative morbidity and recovery after administrating methylprednisolone in super-obese patients undergoing open surgery. METHODS:Sixty super-obese patients with BMI ≥50 kg/m2 (mean 57.48 ± 7.33), mean age of 39 ±9 years, who underwent an open bariatric procedure, were enrolled. Thirty patients (group A) were allocated to a preoperative single dose of 30 mg/kg (ideal body weight) methylprednisolone versus placebo (group B, 30 patients). Endpoints included assessment of IL-6 and CRP; evaluation of postoperative pulmonary function, pain management, nausea, and vomiting; and documentation of postoperative complications. RESULTS: Significant improvement in spirometry parameters and arterial blood gas analysis, in the first and third postoperative days, was observed in the methylprednisolone group. IL-6and CRP levels were significantly lower in that group. Administration of methylprednisolone was associated with less postoperative pain, nausea, and vomiting, with no statistical difference in septic complications. CONCLUSIONS: Preoperative administration of a single high dose of methylprednisolone in super-obese patients undergoing open surgery inhibits the inflammatory signaling cascade, lessens the systemic inflammatory response, and results in fewer pulmonary complications and better patient recovery.
RCT Entities:
BACKGROUND: Surgery stimulates an intense systemic inflammatory response which might increase postoperative morbidity. Corticosteroids may reduce this inflammatory reaction. The purpose of this study was to investigate any possible effect on postoperative morbidity and recovery after administrating methylprednisolone in super-obesepatients undergoing open surgery. METHODS: Sixty super-obesepatients with BMI ≥50 kg/m2 (mean 57.48 ± 7.33), mean age of 39 ± 9 years, who underwent an open bariatric procedure, were enrolled. Thirty patients (group A) were allocated to a preoperative single dose of 30 mg/kg (ideal body weight) methylprednisolone versus placebo (group B, 30 patients). Endpoints included assessment of IL-6 and CRP; evaluation of postoperative pulmonary function, pain management, nausea, and vomiting; and documentation of postoperative complications. RESULTS: Significant improvement in spirometry parameters and arterial blood gas analysis, in the first and third postoperative days, was observed in the methylprednisolone group. IL-6 and CRP levels were significantly lower in that group. Administration of methylprednisolone was associated with less postoperative pain, nausea, and vomiting, with no statistical difference in septic complications. CONCLUSIONS: Preoperative administration of a single high dose of methylprednisolone in super-obesepatients undergoing open surgery inhibits the inflammatory signaling cascade, lessens the systemic inflammatory response, and results in fewer pulmonary complications and better patient recovery.
Authors: Melissa Nespeca Mendes; Rosana de Souza Monteiro; Fernando Antonio Nogueira da Cruz Martins Journal: Rev Bras Anestesiol Date: 2009 Sep-Oct Impact factor: 0.964
Authors: H A Hennein; H Ebba; J L Rodriguez; S H Merrick; F M Keith; M H Bronstein; J M Leung; D T Mangano; L J Greenfield; J S Rankin Journal: J Thorac Cardiovasc Surg Date: 1994-10 Impact factor: 5.209
Authors: Stephanie Weibel; Gerta Rücker; Leopold Hj Eberhart; Nathan L Pace; Hannah M Hartl; Olivia L Jordan; Debora Mayer; Manuel Riemer; Maximilian S Schaefer; Diana Raj; Insa Backhaus; Antonia Helf; Tobias Schlesinger; Peter Kienbaum; Peter Kranke Journal: Cochrane Database Syst Rev Date: 2020-10-19