Efficacy of Preoperative Single Dose Intravenous Dexamethasone in Laparoscopic Cholecystectomy: A Randomized Double-Blind Placebo-Controlled Trial

Phaiwit Sriphatphiriyakun; Yada Chumongkhon

doi:10.64387/tjs.2025.272418

Authors

Phaiwit Sriphatphiriyakun Department of Surgery, Suratthani Hospital, Surat Thani
Yada Chumongkhon Department of Surgery, Surat Thani Hospital, Surat Thani

DOI:

https://doi.org/10.64387/tjs.2025.272418

Keywords:

Laparoscopic cholecystectomy, Dexamethasone, Postoperative pain

Abstract

Background: Postoperative pain following laparoscopic cholecystectomy (LC) is complex and influenced by multiple factors. Dexamethasone has been investigated for its potential to reduce postoperative pain and nausea, but its efficacy remains controversial.

Materials and Methods: This prospective, randomized, double-blind, controlled trial included 108 patients undergoing elective LC. Patients were randomly assigned to receive either 5 mg dexamethasone (study group) or 1 ml normal saline (control group) 1–2 hours before surgery. Postoperative pain was assessed using the Visual Analog Scale (VAS) at 0, 2, 6, 12, and 24 hours. Data on analgesic use, postoperative nausea and vomiting (PONV), complications, and length of hospital stay were also collected. Statistical analyses were conducted using SPSS, with a p-value < 0.05 considered significant.

Results: No statistically significant differences in VAS scores were observed between the dexamethasone and control groups at any time point. Morphine use was similarly low in both groups (2.0 ± 2.9 mg vs. 2.2 ± 3.6 mg, p > 0.05), with about half of the patients requiring no morphine. PONV was less frequent in the dexamethasone group (5.7% vs. 11.1%), but the difference was insignificant. Length of hospital stay was identical in both groups (2.3 ± 0.5 days).

Conclusion: Dexamethasone did not significantly reduce postoperative pain or morphine use in LC patients with low baseline pain scores. Although PONV was less frequent in the dexamethasone group, the difference was not statistically significant. Future studies with larger sample sizes and standardized postoperative care are needed to clarify its role in LC pain management.

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