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Table 1 Included studies characteristics, intervention and control groups extracted, primary study outcome and pain outcomes reported

From: What is the impact of dexamethasone on postoperative pain in adults undergoing general anaesthesia for elective abdominal surgery: a systematic review and meta-analysis

Study 1st author year Country Procedures Participants included, no Participant characteristics Intervention(s) and control(s) Primary outcome(s) Pain outcome(s) reported
Alghanem 2010 (Alghanem et al., 2010) Jordan Laparoscopic cholecystectomy 180 ASA ≤ 2
Age 18–70
Mix M/F
I: Intraoperative dexamethasone 8 mg IV
C: Ondansetron or saline
PONV Pain scores
Areeruk 2016 (Areeruk et al., 2016) Thailand Gynaecological laparotomy via pfannenstiel incision 49 ASA ≤ 2
Age 18-65
I: Intraoperative dexamethasone 8 mg IV
C: Saline
Total morphine consumption Pain scores
Opioid consumption
Badawy 2015 (Badawy & Sakka, 2015) Egypt Total abdominal hysterectomy 38 ASA ≤2
Age 40–70
I: Preoperative
dexamethasone 8 mg IV + gabapentin 800 mg PO
C: Saline + gabapentin
Time to first analgesia Pain scores
Time to first analgesia
Opioid consumption
Bataille 2016 (Bataille et al., 2016) France Laparoscopic sleeve gastrectomy 117 ASA ≤ 3
Age 18–75
BMI >40
≥ 2 RFs PONV
Mix M/F
I: Intraoperative dexamethasone 4 mg + ondansetron 4 mg IV
C: Saline
PONV Pain scores
Batistaki 2019 (Batistaki et al., 2019) Greece Laparoscopic cholecystectomy 44 ASA ≤ 3
Age 18–75
Predominantly female
I: Intraoperative dexamethasone 5 mg
C: Saline
Reversal NMB Pain scores
Benevides 2013 (Benevides et al., 2013) Brazil Laparoscopic sleeve gastrectomy 60 ASA 1–3
Age 18+
BMI ≥ 35
I: Intraoperative dexamethasone 8 mg + ondansetron 8 mg IV
C: Saline + ondansetron
PONV
Rescue antiemetic use
Opioid consumption
PACU LOS
Bianchin 2007 (Bianchin et al., 2007) Italy Laparoscopic cholecystectomy 73 ASA ≤ 2
Predominantly female
I: Preoperative
dexamethasone 8 mg IV
C: Saline
PONV Pain scores
Biligin 2010 (Bilgin et al., 2010) Turkey Total abdominal hysterectomy + bilateral salpingoophorectomy 160 ASA ≤ 2
Age 20-60
I: Preoperative
dexamethasone 8 mg IV
C: Saline or ondansetron or metoclopramide
PONV Pain scores
Bisgaard 2003 (Bisgaard et al., 2003) Denmark Laparoscopic cholecystectomy 80 ASA ≤ 2
Age < 75
Predominantly female
I: Preoperative
dexamethasone 8 mg IV
C: Saline
Pain
Fatigue
Pain Scores
Opioid consumption
PACU LOS
Coloma 2002 (Coloma et al., 2002) USA Laparoscopic cholecystectomy 140 ASA ≤ 2
Predominantly female
I: Intraoperative
dexamethasone 4 mg IV
C: Saline
Recovery times Time to first analgesia
Opioid consumption
PACU LOS
Corcoran 2017 (Corcoran et al., 2017) Australia Major laparoscopic gynaecological surgery 31 ASA ≤ 2
Age 18–60
Surgery > 90 min
≥ 1-night stay
I: Intraoperative
dexamethasone 4 mg IV
C: Saline
Immune response Pain scores
De Oliveira 2011 (De Oliveira Jr. et al., 2011b) USA Laparoscopic gyanecological surgery 106 ASA ≤ 2 I: Preoperative
dexamethasone 0.05 or 0.1 mg kg−1 IV
C: Saline
QoR-40 Pain scores
Time to first analgesia
Opioid consumption
Elhakim 2002 (Elhakim et al., 2002) Egypt Laparoscopic cholecystectomy 180 Predominantly male I: Preoperative
dexamethasone 2 or 4 or 8 or 16 mg IV
C: Saline or ondansetron
PONV Pain scores
Time to first analgesia
Opioid consumption
Feo 2006 (Feo et al., 2006) Italy Laparoscopic cholecystectomy 101 ASA ≤ 3
F>M
I: Preoperative
dexamethasone 8mg IV
C: Saline
Pain
PONV
Analgesic and antiemetic requirements
Pain scores
Fukami 2009 (Fukami et al., 2009) Japan Laparoscopic cholecystectomy 80 Mix M/F I: Preoperative
dexamethasone 8 mg IV
C: Saline
PONV
Pain
Fatigue
Analgesic and antiemetic requirements
Pain scores
Gautam 2008 (Gautam et al., 2008) Nepal Laparoscopic cholecystectomy 142 ASA ≤ 2
Age 23–65
I: Preoperative
dexamethasone 8 mg IV or dexamethasone 8 mg IV + ondansetron 4 mg
C: Ondansetron
PONV Pain scores
Time to first analgesia
Opioid consumption
Hammas 2002 (Hammas et al., 2002) Sweden Cholecystectomy, Inguinal hernia repair 76 ASA ≤ 2
Predominantly male
I: Intraoperative dexamethasone 4 mg + ondansetron 4 mg + droperidol 1.25 mg + metoclopramide 10 mg IV
C: Propofol infusion
PONV Opioid consumption
Ionescu 2014 (Ionescu et al., 2014) Romania Laparoscopic cholecystectomy 42 ASA ≤ 2
Predominantly female
I: Preoperative
dexamethasone 4 mg IV
C: Saline
Immune response Opioid consumption
Jo 2012 (Jo et al., 2012) Korea Laparoscopic cholecystectomy 120 ASA ≤ 2
Female
Age 21–64
BMI < 35
I: Preoperative dexamethasone
8mg IV + saline intraoperative or preoperative dexamethasone 8mg IV + ramosetron 0.3 mg IV intraoperative
C: Saline + ramosetron
PONV Pain scores
Jokela 2009 (Jokela et al., 2009) Finland Laparoscopic hysterectomy +/- oophorectomy 120 ASA ≤ 3
BMI < 35
I: Preoperative
dexamethasone 5 or 10 or 15mg IV
C: Saline
Pain
Opioid consumption
Pain scores
Time to first analgesia
Opioid consumption
Kasagi 2013 (Kasagi et al., 2013) Japan Hysterectomy, cystectomy, myomectomy 60 ASA ≤ 2
Age 20–-50
Benign disease
I: Preoperative
dexamethasone 8 mg IV
C: Droperidol
PONV Pain scores
Kassim 2018 (Kassim et al., 2018) Egypt Laparoscopic gyanecological surgery for infertility 50 ASA ≤ 2
Age 25–35
I: Preoperative
dexamethasone 0.1 mg kg−1 IV + duloxetine 60 mg PO
C: Saline + duloxetine
Pethidine requirements Pain scores
Time to first analgesia
Opioid consumption
Ko-iam 2015 (Ko-Iam et al., 2015) Thailand Laparoscopic cholecystectomy 100 ASA ≤ 2
Age 18–75
Predominantly female
I: Intraoperative dexamethasone 8 mg + metoclopramide 10 mg IV
C: Metoclopramide
PONV Pain scores
Opioid consumption
Kurz 2015 (Kurz et al., 2015) USA Colorectal resection 555 Age ≤ 80
Surgery 2–6 h
I: Intraoperative dexamethasone 4 mg IV & 30% oxygen or intraoperative dexamethasone 4 mg IV & 80% oxygen
C: Saline + oxygen
Surgical site infection Pain scores
Lee 2017 (Lee et al., 2017) Republic of Korea Laparoscopic cholecystectomy 380 ASA ≤ 2
Age 18–45
Mix M/F
I: Preoperative dexamethasone 5 mg IV
C: Saline
Morphine requirements Pain scores
Time to first analgesia
Opioid consumption
Lim 2011 (Lim et al., 2011) Korea Laparoscopic cholecystectomy 120 ASA ≤ 2
M>F
I: Preoperative dexamethasone 8 mg + intraoperative saline or preoperative saline + intraoperative dexamethasone 8 mg IV
C: Saline
Pain Pain scores
Opioid consumption
Liu 1998 (Liu et al., 1998) Taiwan Major gynaecological surgery 60 ASA ≤ 2 I: Intraoperative dexamethasone 10 mg
C: Saline
PONV
Pain
Pain scores
Opioid consumption
Liu 1999 (Liu et al., 1999) Taiwan Abdominal and radical hysterectomy, myomectomy 150 ASA ≤ 2 I: Preoperative
dexamethasone 1.25 or 2.5 or 5 or 10 mg IV
C: Saline
PONV Pain scores
Time to first analgesia
Opioid consumption
Lopez-Olaondo 1996 (Lopez-Olaondo et al., 1996) Spain Major abdominal gynaecological surgery 100 ASA ≤ 2
Age 18–65
45–90 kg
I: Preoperative
dexamethasone 8 mg + ondansetron 4 mg IV
C: Saline + ondansetron
PONV Pain scores
Opioid consumption
Maddali 2003 (Maddali et al., 2003) Oman Laparoscopic gyanecological surgery 120 ASA ≤ 2
Age ≤ 60
I: Preoperative
dexamethasone 8 mg + ondansetron 4 mg IV or dexamethasone 8mg + metoclopramide 10 mg
C: Saline
PONV Pain scores
Mathiesen 2009 (Mathiesen et al., 2009) Denmark Abdominal hysterectomy +/- salpingoophorectomy 76 ASA ≤ 2
Age 18–75
BMI 18–32
I: Preoperative
dexamethasone 8 mg IV+ paracetamol 1g PO+ pregabalin 300 mg PO
C: Saline + paracetamol + gabapentin
Morphine consumption Pain scores
Opioid consumption
McKenzie 1997 (McKenzie et al., 1997) USA Abdominal or vaginal hysterectomy, laparotomy, anterior and posterior repair 80 ASA ≤ 3
Age 18–65
I: Intraoperative dexamethasone 20 mg IV + ondansetron 4 mg IV
C: Saline + ondansetron
PONV Pain scores
Opioid consumption
Murphy 2011 (Murphy et al., 2011) USA Laparoscopic cholecystectomy 115 ASA ≤ 3
F>M
I: Preoperative
dexamethasone 8 mg IV
C: Saline
QoR-40 Pain scores
Opioid consumption
PACU LOS
Murphy 2014 (Murphy et al., 2014) USA Laparoscopic or open hysterectomy 195 ASA ≤ 3
Age 18–80
I: Intraoperative dexamethasone 4 or 8 mg IV
C: Saline
Perioperative glucose concentration Pain scores
Opioid consumption
PACU LOS
Nesek-Adam 2007 (Nesek-Adam et al., 2007) Croatia Laparoscopic cholecystectomy 160 ASA ≤ 2
Predominantly female
I: Intraoperative dexamethasone 8 mg IV + saline or dexamethasone 8 mg + metoclopramide 10 mg
C: Saline or saline + metoclopramide
PONV Pain scores
Time to first analgesia
Olajumoke 2013 (Olajumoke et al., 2013) Nigeria Total abdominal hysterectomy, myomectomy 96 ASA ≤ 2
Age 18–65
I: Intraoperative dexamethasone 4 mg IV
C: Saline
PONV PACU LOS
Pan 2008 (Pan et al., 2008) USA Laparoscopic gynaecological surgery 60 ASA ≤ 2
Age ≥18
≥ 3 emetic risk factors
I: Intraoperative dexamethasone 8 mg + ondansetron 4 mg IV + ondansetron PO D0,1,2
C: Saline + ondansetron
PONV Pain scores
Opioid consumption
PACU LOS
Pauls 2015 (Pauls et al., 2015) USA Major vaginal reconstructive surgery 63 ASA ≤ 3 I: Preoperative
dexamethasone 8 mg IV
C: Saline
Quality of recovery Pain scores
Opioid consumption
Regasa 2020 (Regasa et al., 2020) Ethiopia Major gynaecological surgery 96 ASA ≤ 2
Age 18–65
I: Intraoperative dexamethasone 8 mg IV + saline or dexamethasone 8 mg + metoclopramide 10 mg
C: metoclopramide
PONV Opioid consumption
Rothenberg 1998 (Rothenberg et al., 1998) USA Laparoscopic gynaecological surgery 95 ASA ≤ 2 I: Intraoperative
dexamethasone 0.17 mg kg−1 IV
C: Droperidol
PONV Pain scores
Opioid consumption
PACU LOS
Ryu 2013 (Ryu et al., 2013) Korea Laparoscopic cholecystectomy 72 ASA ≤ 2
Age 25–65
I: Intraoperative dexamethasone 8 mg + ramosetron 0.3 mg IV
C: Saline + ramosetron
PONV Pain scores
Sanchez-Ledesma 2002 (Sanchez-Ledesma et al., 2002) Spain Hysterectomy, myomectomy/adnexectomy, oncological gynaecological reduction 90 ASA ≤ 2
Age 18–65
45–90 kg
I: Intraoperative dexamethasone 8 mg + droperidol 1.25 mg IV + postoperative droperidol or dexamethasone 8 mg + ondansetron 4 mg and postoperative saline
C: Ondansetron + droperidol
PONV Pain scores
Opioid consumption
Sanchez-Rodriquez 2010 (Sanchez-Rodriguez et al., 2010) Mexico Laparoscopic cholecystectomy 210 ASA ≤ 2
Age ≤ 80
F>M
I: Preoperative
dexamethasone 8 mg IV
C: Placebo
PONV
Pain
Fatigue
Additional analgesic and antiemetic drugs
Pain scores
Shrestha 2014 (Shrestha et al., 2014) Nepal Laparoscopic cholecystectomy 120 ASA ≤ 2
Age 17–75
Predominantly female
I: Preoperative
dexamethasone 8 mg + pheniramine 45.5 mg IV
C: Saline
Pain
Systemic acute phase response
Pain scores
Sistla 2009 (Sistla et al., 2009) India Laparoscopic cholecystectomy 70 Predominantly female I: Preoperative
dexamethasone 8 mg IV
C: Saline
Morphine consumption Pain scores
Opioid consumption
Thangaswamy 2010 (Thangaswamy et al., 2010) India Total laparoscopic hysterectomy 55 ASA ≤ 2
Age 18–60
I: Preoperative
dexamethasone 4 or 8 mg IV
C: Saline
Fentanyl consumption Pain scores
Time to first analgesia
Opioid consumption
Tolver 2012 (Tolver et al., 2012) Denmark Transabdominal preperitoneal groin repair 73 ASA ≤ 2
Age 18–5
I: Preoperative
dexamethasone 8 mg IV
C: Saline
Pain Pain scores
Opioid consumption
Viriyaroj 2015 (Viriyaroj et al., 2015) Thailand Laparoscopic cholecystectomy 80 Predominantly female I: Preoperative
dexamethasone 8 mg IV
C: Saline
Pain
Analgesic consumption
Pain scores
Opioid consumption
Wang 1999 (Wang et al., 1999) Taiwan Laparoscopic cholecystectomy 78 ASA ≤ 2
Age 30–55
Predominantly female
I: Preoperative
dexamethasone 8 mg IV
C: Saline
PONV Pain scores
Opioid consumption
Wang 2000 (Wang et al., 2000) Taiwan Total abdominal hysterectomy 120 ASA ≤ 2
Age 35-45
I: Preoperative dexamethasone 10 mg IV + postoperative saline or preoperative saline + postoperative dexamethasone 10 mg IV
C: Saline
PONV Pain scores
Opioid consumption
Wu 2009 (Wu et al., 2009) Taiwan Anorectal surgery 60 ASA ≤ 2
Predominantly female
I: Preoperative dexamethasone 5 mg IV
C: Saline
PONV Pain scores
Opioid consumption
Yuksek 2003 (Yuksek et al., 2003) Turkey Laparoscopic gyanecological surgery 60 ASA ≤ 2
19–62
I: Preoperative dexamethasone 8 mg IV
C: Saline or ondansetron
PONV Pain scores
Time to first analgesia
  1. PONV postoperative nausea and vomiting, NMB neuromuscular blockade, PACU LOS post-anaesthesia care unit length of stay