Dexamethasone Reduces Surgical Stress After Robotic-Assisted Hysterectomy: Study

A new study published in the journal of BMC Surgery showed that in patients receiving robotic-assisted hysterectomy, dexamethasone dramatically reduced postoperative C-reactive protein (CRP) levels, suggesting that it may lessen the inflammatory response and general surgical stress related to the surgery.

Surgical trauma invariably sets off a complicated physiological chain reaction known as the surgical stress response, which is marked by significant neuroendocrine and metabolic alterations. Rapid systemic production of pro-inflammatory cytokines, particularly Interleukin-6 and Tumor Necrosis Factor-alpha, and an increase in acute-phase proteins, such as CRP, are characteristics of this reaction.

Although this inflammatory process is necessary for the initial defense and repair of tissue, an overreaction or protracted response can result in unfavorable postoperative outcomes, such as a longer recovery period, more discomfort, and a higher chance of surgical problems. Perioperative injection of dexamethasone has become a cornerstone of improved recovery regimens globally, to reduce these side effects.

A single preoperative dosage of dexamethasone considerably reduces the postoperative surge in important inflammatory markers including CRP and interleukin-6, according to clinical data. Dexamethasone not only lessens the intensity of the systemic inflammatory response by successfully calming this biochemical storm, but it also directly reduces nausea, lessens pain, and eventually helps surgical patients recover physiologically more quickly. Researchers sought to assess dexamethasone's impact on lowering CRP, in this first randomized trial of the drug in robotic hysterectomy.

A randomized experiment comparing a preoperative dosage of 24 mg dexamethasone with a placebo was conducted on women scheduled for robotic-assisted hysterectomy. Blood tests were taken, and at 0, 4, 8, 12, and 24 hours after surgery, visual analog scale ratings for pain, postoperative nausea and vomiting, and medication usage during admission were noted.

The dexamethasone group had reduced postoperative CRP levels at 12 and 24 hours among the 112 women who were enrolled. Over time, the dexamethasone group experienced less postoperative nausea and vomiting (p = 0.039 without correction; p = 0.02 with adjustment).

Repeated-measures analysis of CRP changes revealed extremely significant differences without and with adjustment for age, BMI, and baseline CRP (both p<0.001). During the postoperative phase, the dexamethasone group showed significantly reduced CRP levels.

Overall, dexamethasone may play a part in further lowering postoperative CRP levels to reduce surgical stress during robotic-assisted hysterectomy.

Source:

Kaiser, K., Karstensen, S. H., Petersen, S. R., Nielsen, K. A., Valorenzos, A. V., Strøm, T., Gögenur, I., Balsevicius, L., & Lauszus, F. F. (2026). The effect of dexamethasone on inflammatory markers of surgical stress: a randomized trial in robotic hysterectomy. BMC Surgery. https://doi.org/10.1186/s12893-026-03664-y