Bisgaard Thue, Schulze Svend, Christian Hjortsø Niels, Rosenberg Jacob, Bjerregaard Kristiansen Viggo
Surg Endosc. 2008 Feb;22(2):566-72. doi: 10.1007/s00464-007-9713-y. Epub 2007 Dec 20.
Intravenous administration of dexamethasone 90 min before laparoscopic cholecystectomy improves surgical outcome but may be impractical. The objective of this study was to assess the clinical efficacy of oral self-administration of prednisone 2 h before ambulatory laparoscopic cholecystectomy.
In a double-blind placebo-controlled study, 200 patients were randomized to oral administration of prednisone (50 mg) or placebo 2 h before laparoscopic cholecystectomy. Patients received a similar standardized anaesthetic, surgical, and analgesic treatment. The primary outcome was pain 24 h after surgery and secondary outcomes were fatigue and malaise 24 h after surgery. Outcome parameters were registered before operation, on the day of operation, and the following two days. Analgesic and antiemetic requirements were registered, and nausea and vomiting were assessed twice within the first 24 h. Side-effects and 30-day follow-up for morbidity were registered.
Data from 184 patients were available for statistical analysis. There were no significant differences in side-effects or complications between the surgical groups (P > 0.05). No significant intergroup differences in 24-h pain, fatigue or malaise scores or any other variables were found (P > 0.05).
There is no important clinical gain of preoperative oral steroid administration compared with placebo in patients undergoing laparoscopic cholecystectomy.
在腹腔镜胆囊切除术90分钟前静脉注射地塞米松可改善手术效果，但可能不切实际。本研究的目的是评估在门诊腹腔镜胆囊切除术2小时前口服泼尼松的临床疗效。
在一项双盲安慰剂对照研究中，200例患者在腹腔镜胆囊切除术2小时前被随机分为口服泼尼松（50毫克）组或安慰剂组。患者接受相似的标准化麻醉、手术和镇痛治疗。主要结局是术后24小时的疼痛，次要结局是术后24小时的疲劳和不适。结局参数在术前、手术当天及随后两天进行记录。记录镇痛和止吐需求，并在最初24小时内对恶心和呕吐进行两次评估。记录副作用和30天的发病随访情况。
184例患者的数据可用于统计分析。手术组之间在副作用或并发症方面无显著差异（P>0.05）。在24小时疼痛、疲劳或不适评分或任何其他变量方面未发现显著的组间差异（P>0.05）。
对于接受腹腔镜胆囊切除术的患者，与安慰剂相比，术前口服类固醇并无重要的临床获益。
