This study aims to investigate how the timing of dexamethasone administration during anesthesia induction affects patient outcomes after surgery. Dexamethasone is commonly used to reduce nausea and inflammation during and after surgery. However, it is not yet known if administering dexamethasone at different times during induction (before, during, or after specific anesthetic drugs) leads to better recovery and fewer postoperative complications.
Participants will be randomly assigned to one of three groups: one group will receive dexamethasone before fentanyl, another after the muscle relaxant, and a third group will not receive dexamethasone. This approach will help us understand if the timing of dexamethasone affects patient outcomes such as nausea, pain, and recovery quality. The study is triple-blinded, meaning that the participants, care providers, and investigators will not know which group the participants are in, to ensure unbiased results.
Adults aged 18 years or older
Scheduled for elective non cardiac surgery requiring general anesthesia
surgery last at least 90 minutes
scare of more than 5 cm Able to provide informed consent Eligible for dexamethasone administration as part of routine perioperative care
Known allergy or hypersensitivity to dexamethasone or related corticosteroids
History of uncontrolled diabetes mellitus or significant blood glucose management issues, as dexamethasone may affect glucose levels
Severe cardiovascular instability or hemodynamic issues contraindicating study participation
Patients receiving immunosuppressive therapy or with conditions affecting the immune system, as corticosteroids may alter immune responses
Parallel
Dexamethasone
DrugDexamethasone will be administered intravenously at varying times during anesthesia induction to assess the impact of timing on postoperative outcomes. Participants will be randomized into one of three groups: one group will receive dexamethasone before the administration of fentanyl, a second group will receive it after the administration of a muscle relaxant, and a third control group will not receive dexamethasone. This timing variation aims to determine the optimal administration point to improve outcomes, including postoperative nausea, pain, glycemic stability, and hemodynamic response.
Incidence of Postoperative Nausea and Vomiting (PONV)
To assess the frequency and severity of nausea and vomiting within the first 24 hours after surgery using APFEL scale
Postoperative Pain Levels
The Visual Analog Scale (VAS) ranges from 0 to 10, where 0 represents "no pain" and 10 represents "worst possible pain." Higher scores indicate greater pain intensity, representing a worse outcome.
Glycemic Variation before induction, 2 hours, and Immediate Postoperative Period
Evaluate blood glucose levels at baseline Baseline (immediately before induction), 2 hours after induction, and immediately after surgery
Hypotension on Induction and during surgery
Record events of hypotension defined my mean arterial pressure (MAP) \<65 mmHg or systolic arterial pressure (SAP) \<90 mmHg or a drop by \> 30% of baseline MAP or SAP.
Incidence of Postoperative Complications during first 24 postoperative hours
Record any adverse events or complications that occur within the first 24 hours postoperatively, such as infections, respiratory issues, or other related complications.
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AABDI Mohammed
Lead sponsor
University Abdelmalek Essaadi faculty of medicine and pharmacy Tangier
Sponsor institution
University Hospital Center Mohammed VI Tangier, Morocco
Collaborator
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