The effect of single low-dose dexamethasone on vomiting during awake craniotomy

Kotoe Kamata, Nobutada Morioka, Takashi Maruyama, Noriaki Komayama, Masayuki Nitta, Yoshihiro Muragaki, Takakazu Kawamata, Makoto Ozaki

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: Intraoperative vomiting leads to serious respiratory complications that could influence the surgical decision-making process for awake craniotomy. However, the use of antiemetics is still limited in Japan. The aim of this study was to investigate the effect of prophylactically administered single low-dose dexamethasone on the incidence of vomiting during awake craniotomy. The frequency of hyperglycemia was also examined. Methods: We conducted a retrospective case review of awake craniotomy for glioma resection between 2012 and 2015. Results: Of the 124 patients, 91 were included in the analysis. Dexamethasone was not used in 43 patients and the 48 remaining patients received an intravenous bolus of 4.95 mg dexamethasone at anesthetic induction. Because of stable operating conditions, no one required conscious sedation throughout functional mapping and tumor resection. Although dexamethasone pretreatment reduced the incidence of intraoperative vomiting (P = 0.027), the number of patients who complained of nausea was comparable (P = 0.969). No adverse events related to vomiting occurred intraoperatively. Baseline blood glucose concentration did not differ between each group (P = 0.143), but the samples withdrawn before emergence (P = 0.018), during the awake period (P < 0.0001) and at the end of surgery (P < 0.0001) showed significantly higher glucose levels in the dexamethasone group. Impaired wound healing was not observed in either group. Conclusion: A single low-dose of dexamethasone prevents intraoperative vomiting for awake craniotomy cases. However, as even a small dose of dexamethasone increases the risk for hyperglycemia, antiemetic prophylaxis with dexamethasone should be administered after careful consideration. Monitoring of perioperative blood glucose concentration is also necessary.

Original languageEnglish
Pages (from-to)941-948
Number of pages8
JournalJournal of Anesthesia
Volume30
Issue number6
DOIs
Publication statusPublished - 2016 Dec 1
Externally publishedYes

Keywords

  • Awake craniotomy
  • Dexamethasone
  • Intraoperative complications
  • Vomiting

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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    Kamata, K., Morioka, N., Maruyama, T., Komayama, N., Nitta, M., Muragaki, Y., Kawamata, T., & Ozaki, M. (2016). The effect of single low-dose dexamethasone on vomiting during awake craniotomy. Journal of Anesthesia, 30(6), 941-948. https://doi.org/10.1007/s00540-016-2243-9