IV Dexamethasone after anesthesia induction reduces Postoperative Ileus and pain in IBD: Study

Inflammatory bowel disease (IBD) refers to two conditions: ulcerative colitis and Crohn's disease. Excessive postoperative inflammatory response is common after surgery for inflammatory bowel disease (IBD), and it may be linked to an increased risk of postoperative ileus.

A new study has discovered that a single intravenous 8-mg dose of dexamethasone given immediately after anesthesia induction reduced the incidence of prolonged postoperative ileus, the intensity of postoperative pain, and the length of stay for inflammatory bowel disease patients undergoing elective surgery. This study was conducted by Tenghui Zhang and team, results of which are published in Journal of Inflammatory Bowel Diseases on 2nd December, 2021.

The purpose of this study was to look at the role of perioperative dexamethasone in postoperative ileus after inflammatory bowel disease surgery. During the induction of anesthesia, patients undergoing elective inflammatory bowel disease surgery were randomly assigned to either an intravenous 8-mg dose of dexamethasone (n = 151) or a placebo (n = 151). The incidence of prolonged postoperative ileus was the primary outcome. The incidence of reported nausea or vomiting, the time to first passage of flatus and stool, GI-2 recovery, postoperative pain, length of stay, and surgical complications were all secondary outcomes.

The findings of this study were:

1. When compared to controls, patients who received dexamethasone had a lower incidence of prolonged postoperative ileus, a shorter time to first passage of stool, GI-2 recovery, a shorter postoperative length of stay, and less postoperative pain.

2. Furthermore, there were no significant differences between the groups in terms of postoperative nausea or vomiting, major postoperative complications, or surgical site infections.

3. Only patients with Crohn's disease, restored bowel continuity, colon/ rectal resections, and those undergoing open surgery saw a benefit.

In conclusion, the use of a single 8-mg dose of dexamethasone reduced the occurrence of postoperative ileus. This treatment has been proven to be safe and effective in inflammatory bowel disease patients, particularly those with Crohn's disease.

Reference:

Zhang, T., Xu, Y., Yao, Y., Jin, L., Liu, H., Zhou, Y., Gu, L., Ji, Q., Zhu, W., & Gong, J. (2021). Randomized Controlled Trial: Perioperative Dexamethasone Reduces Excessive Postoperative Inflammatory Response and Ileus After Surgery for Inflammatory Bowel Disease. In Inflammatory Bowel Diseases (Vol. 27, Issue 11, pp. 1756–1765). Oxford University Press (OUP). https://doi.org/10.1093/ibd/izab065