Infection after urogynecologic surgery with the use of dexamethasone for nausea prophylaxis

• Published in: Journal of clinical anesthesia 2012-11, Vol.24 (7), p.549-554
• Main Authors: Gali, Bhargavi, MD, Burkle, Christopher M., MD, JD, Klingele, Christopher J., MD, Schroeder, Darrell, MS, Jankowski, Christopher J., MD
• Format: Article
• Language: English
• Subjects: Abdomen; Adult; Aged; Anesthesia; Anesthesia & Perioperative Care; Antibiotics; Antiemetics - adverse effects; Antiemetics - therapeutic use; Confidence intervals; Dexamethasone; Dexamethasone - adverse effects; Dexamethasone - therapeutic use; Female; Follow-Up Studies; Gynecologic Surgical Procedures - adverse effects; Gynecologic Surgical Procedures - methods; Heart attacks; Hospitals, University; Humans; Hyperglycemia; Incidence; Infections; Middle Aged; Multivariate Analysis; Operative Time; Pain Medicine; Patient satisfaction; Perioperative complications; Postoperative Complications; Postoperative Nausea and Vomiting - prevention & control; Postoperative nausea and vomiting prophylaxis; Respiratory diseases; Retrospective Studies; Studies; Surgery; Surgical Wound Infection - epidemiology; Surgical Wound Infection - etiology; Urinary tract infection; Urinary Tract Infections - epidemiology; Urinary Tract Infections - etiology; Urogenital system; Urogynecologic surgery; Urologic Surgical Procedures - adverse effects; Urologic Surgical Procedures - methods; Wound healing; Wound Infection
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/j.jclinane.2012.03.009

Abstract Study Objective To determine if a single perioperative dose of dexamethasone increases the risk of infection after urogynecologic surgery. Design Retrospective chart review (2004 - 2006) of patient records from the preoperative period to follow-up of 6 weeks from procedure. Setting University-affiliated tertiary-care hospital. Measurements The records of 574 ASA physical status 1, 2, and 3 women who had undergone urogynecologic surgery and who consented to have their information utilized for research were studied. The perioperative course of those who did and did not receive single-dose dexamethasone (4-8 mg) for postoperative nausea and vomiting prophylaxis was compared. Data collected included dexamethasone use, patient age, body mass index, ASA physical status, preexisting cardiovascular or respiratory disease, diabetes mellitus, type of surgery (vaginal vs abdominal), type of anesthesia (general vs regional, or combination), and duration of surgery. Postoperative infectious complications, including urinary tract infection (UTI), wound infection, other infections, and other complications, were noted. Main Results Univariate and multivariable analysis found no significant association between single-dose dexamethasone use and perioperative complications, including wound infection and UTI. There was an increased incidence of UTI with vaginal versus abdominal procedures, and longer duration of surgery. Conclusions There was no significant association between single-dose dexamethasone and perioperative infectious complications.