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High vs Low Dose Dexamethasone on Complications in the Immediate Postoperative Phase After Mastectomy

Effect of High vs Low Dose Intravenous Dexamethasone on Complications in the Immediate Postoperative Phase After Mastectomy- a Randomized, Double-blind, Controlled Trial

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03125941
Acronym
DEX-MAS
Enrollment
130
Registered
2017-04-24
Start date
2017-03-27
Completion date
2018-04-22
Last updated
2019-12-02

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Breast Cancer, Dexamethasone, Glucocorticoids, Mastectomy, Nausea and Vomiting, Postoperative, Pain, Postoperative, Postoperative Complications, Steroid, Systemic Inflammatory Response Syndrome

Brief summary

The aim of this study is to investigate the effect of a single preoperative high-dose steroid injection on complications in the immediate postoperative phase after breast cancer surgery, with removal of the breast (mastectomy). Primary outcome is the proportion patients who require transfer to the post anaesthesia care unit (PACU) and the proportion that can be transferred directly to the ward. Secondary outcomes are organospecific complications in the postanesthesia phase, pain and nausea the first 5 days, seroma and wound infection the first 14 days and readmissions the first 30 days after surgery. The investigators hypothesize that the frequency of transfer to the PACU and organospecific complications will be lower among patients receiving high dose dexamethasone. The investigators hypothesize, that there will be no difference in wound infections, seroma or readmissions.

Detailed description

Post-surgery, patients are traditionally observed and treated in post-anesthesia care units (PACU) until they are discharged to the ward (or directly home) assessed by standardized international discharge criteria. The research project Why in PACU? (Rigshospitalet, Denmark), has since the beginning of 2016 systematically collected and analyzed procedure-related complications in the recovery phase. The complications include pain, nausea/vomiting, circulatory and respiratory problems, orthostatic intolerance and cognitive disorders. Common to all the above-mentioned post-operative problems are the possible links to the inflammatory response caused by the surgical trauma. Glucocorticoids can in this context be central for the reduction of acute postoperative organ dysfunctions, caused by the anti-inflammatory effect. In a number of different surgical procedures, single dose, pre-operative glucocorticoids have been shown to reduce post-operative nausea and vomiting (PONV), acute pain and need of opioids as well as accelerate the convalescence. Meta-analyses also showed that single-dose administration of glucocorticoids (methylprednisolone and dexamethasone) for surgical patients is safe as opposed to long-term treatment. Based on positive results in other procedure-specific studies, all mastectomy patients at Rigshospitalet, have received pre-operative high-dose steroids, in the form of 24 mg dexamethasone injection since mid-2015. This has resulted in a decrease in the proportion of patients who need observation in PACU from 30 % to 10 %. The reduction is primarily due to less pain, less sedation, and lower opioid administration. Whether this is also partly due to a systemic effect (Hawthorn effect) as a result of increased focus on the area cannot be excluded. Prior to creating clinical recommendations and standards, it is required that the results be tested in a randomized, controlled, clinical trial. The study is not placebo-controlled since the positive effects of dexamethasone 8 mg on PONV have been shown in numerous trials, and is already being administered to all patients at the clinic. It would therefore not be ethically correct to withdraw from this practise.

Interventions

DRUGDexamethasone

pre-operative intravenous administration

Sponsors

Rigshospitalet, Denmark
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* planned unilateral mastectomy with or without axillary dissection or sentinel node in the study period * informed signed consent

Exclusion criteria

* Chronic/ongoing use of glucocorticoids (except inhalation therapy) * ongoing use of immunosuppressive therapy * insulin dependent diabetes * pregnancy/breastfeeding * allergies toward study medication, or medication in a standard treatment * contralateral surgery (lumpectomy/mastectomy) at time of mastectomy * surgery cannot be performed

Design outcomes

Primary

MeasureTime frameDescription
Transfer to Post-anesthesia Care Unit (PACU)Within 1 hour post-surgeryNumber of patients meeting criteria for transfer to PACU post-surgery

Secondary

MeasureTime frameDescription
Discharge Score, Arrival at PACUwithin 3 hoursDASAIM score (Danish Society of Anesthesiology and Intensive Care Medicine). The score consists of six modalities: Sedation, Oxygen saturation, blood pressure, heart rate, pain (at rest) and nausea. Each modality has a score between 0 and 3, and patients are considered dischargeable to the ward when the score sum of all criteria is four or less and no single score is above one. Sedation: 0 fully awake, 1, sleeping aroused by verbal stimuli, 2 sleeping, aroused by physical stimuli, 3 sleeping, cannot be aroused. Oxygen saturation (%): 0 ≥ 94, 1 90-93, 2 85-89, 3 \<85. Blood pressure, systolic (mmHg): 0 100-220, 1 90-99. 2 80-89 or \>220, 3\<80. Heart rate; pr. min: 0 50-100, 1 101-120, 2 40-49 or 121-130, 3 \<40 or \>130. Pain (at rest) (Numeric rating scale 0-10): 0 0, 1 0-2, 2 3-6, 3 ≥ 7 Nausea (patient evaluation and nurse observation): 0 none, 1 light, 2 moderate, 3 severe or vomiting.
Discharge Score, Arrival at Wardwithin 3 hoursDASAIM score (Danish Society of Anesthesiology and Intensive Care Medicine). The score consists of six modalities: Sedation, Oxygen saturation, blood pressure, heart rate, pain (at rest) and nausea. Each modality has a score between 0 and 3, and patients are considered dischargeable to the ward when the score sum of all criteria is four or less and no single score is above one. Sedation: 0 fully awake, 1, sleeping aroused by verbal stimuli, 2 sleeping, aroused by physical stimuli, 3 sleeping, cannot be aroused. Oxygen saturation (%): 0 ≥ 94, 1 90-93, 2 85-89, 3 \<85. Blood pressure, systolic (mmHg): 0 100-220, 1 90-99. 2 80-89 or \>220, 3\<80. Heart rate; pr. min: 0 50-100, 1 101-120, 2 40-49 or 121-130, 3 \<40 or \>130. Pain (at rest) (Numeric rating scale 0-10): 0 0, 1 0-2, 2 3-6, 3 ≥ 7 Nausea (patient evaluation and nurse observation): 0 none, 1 light, 2 moderate, 3 severe or vomiting.
Number of Participants With Complication24 hourscomplications requiring treatment until discharge
Total Length of Stay in PACU12 hoursLength of stay in the post-anesthesia care unit (PACU), measured as hours and minutes, from start of procedure, to discharge from PACU
Total Length of Stay in Hospital24-48 hoursLength of stay in hospital, measured from start of procedure to discharge from hospital to home
Secondary Transfer24-48 hoursSecondary transfer to PACU from ward, or to intensive care unit from PACU
Discharge Score,(Modified Aldrete Discharge Score), Operating RoomAt transfer from operating room, within 1 hour post-surgeryDanish Society of Anesthesiology and Intensive Care Medicine (DASAIM) discharge score.Construct: The score consists of six modalities (subscores): Sedation,Oxygen saturation,blood pressure,heart rate,pain (at rest)and nausea.Each modality has a score between 0 and 3,and patients are considered dischargeable to the ward when the score sum of all criteria (total score) is 4 or less and no single score is above 1. All values (subscores) are considered best at 0 and worst at 3. Sedation: 0 fully awake, 1, sleeping aroused by verbal stimuli, 2 sleeping aroused by physical stimuli, 3 sleeping cannot be aroused. Oxygen saturation (%):0 ≥94, 1 90-93, 2 85-89, 3 \<85. Blood pressure, systolic (mmHg): 0 100-220, 1 90-99. 2 80-89 or \>220, 3\<80. Heart rate; pr. min: 0 50-100, 1 101-120, 2 40-49 or 121-130, 3 \<40 or \>130. Pain (at rest) (Numeric rating scale 0-10): 0 0, 1 0-2, 2 3-6, 3 ≥ 7 Nausea (patient evaluation and nurse observation): 0 none, 1 light, 2 moderate, 3 severe or vomiting.
Post Operative Nausea and Vomiting (PONV).days 0-4Self-reported nausea, questionnaire, day 0-4. Number of participants reporting nausea and/or vomiting
Quality of Sleepdays 0-4Self-reported quality of sleep (days 0-4). Questionnaire. Dichotomized to Good sleep or sleep problems, numbers reported are number of patients with sleep problems
Mental Statusdays 0-4Self-reported feelings of restlessness, sadness and fatigue (days 0-4). Questionnaire (anwers possible: yes or no. Numbers are patients answering yes)
Number of Participants With Seroma, Requiring Treatment14 daysSeroma, requiring treatment the first 14 days.
Readmission30 daysAny readmission, days 0-30
Pain, Numeric Rating Scaledays 0-4Self-reported pain (worst and average (average through that day), days 0-4) on a numeric rating scale (NRS) 0-10. 0 is no pain, 10 is worst pain imaginable.. Questionnaire.

Countries

Denmark

Participant flow

Participants by arm

ArmCount
Dexamethasone 8 mg
Dexamethasone 8 mg pre-operative Dexamethasone: pre-operative intravenous administration
65
Dexamethasone 24 mg
Dexamethasone 24 mg pre-operative Dexamethasone: pre-operative intravenous administration
65
Total130

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall Studydid not receive intervention12

Baseline characteristics

CharacteristicDexamethasone 8 mgDexamethasone 24 mgTotal
Age, Continuous66 years63 years65 years
Race and Ethnicity Not Collected0 Participants
Sex: Female, Male
Female
63 Participants65 Participants128 Participants
Sex: Female, Male
Male
2 Participants0 Participants2 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 630 / 64
other
Total, other adverse events
0 / 630 / 64
serious
Total, serious adverse events
5 / 633 / 64

Outcome results

Primary

Transfer to Post-anesthesia Care Unit (PACU)

Number of patients meeting criteria for transfer to PACU post-surgery

Time frame: Within 1 hour post-surgery

Population: primary outcome was per intention to treat, secondary outcomes were per protocol (we had 3 post-randomization exclusions, that did not receive the intervention)

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Dexamethasone 8 mgTransfer to Post-anesthesia Care Unit (PACU)23 Participants
Dexamethasone 24 mgTransfer to Post-anesthesia Care Unit (PACU)23 Participants
p-value: 195% CI: [0.49, 2.05]Chi-squared
Secondary

Discharge Score, Arrival at PACU

DASAIM score (Danish Society of Anesthesiology and Intensive Care Medicine). The score consists of six modalities: Sedation, Oxygen saturation, blood pressure, heart rate, pain (at rest) and nausea. Each modality has a score between 0 and 3, and patients are considered dischargeable to the ward when the score sum of all criteria is four or less and no single score is above one. Sedation: 0 fully awake, 1, sleeping aroused by verbal stimuli, 2 sleeping, aroused by physical stimuli, 3 sleeping, cannot be aroused. Oxygen saturation (%): 0 ≥ 94, 1 90-93, 2 85-89, 3 \<85. Blood pressure, systolic (mmHg): 0 100-220, 1 90-99. 2 80-89 or \>220, 3\<80. Heart rate; pr. min: 0 50-100, 1 101-120, 2 40-49 or 121-130, 3 \<40 or \>130. Pain (at rest) (Numeric rating scale 0-10): 0 0, 1 0-2, 2 3-6, 3 ≥ 7 Nausea (patient evaluation and nurse observation): 0 none, 1 light, 2 moderate, 3 severe or vomiting.

Time frame: within 3 hours

ArmMeasureValue (MEDIAN)
Dexamethasone 8 mgDischarge Score, Arrival at PACU1 score on a scale
Dexamethasone 24 mgDischarge Score, Arrival at PACU1 score on a scale
p-value: 0.294Wilcoxon (Mann-Whitney)
Secondary

Discharge Score, Arrival at Ward

DASAIM score (Danish Society of Anesthesiology and Intensive Care Medicine). The score consists of six modalities: Sedation, Oxygen saturation, blood pressure, heart rate, pain (at rest) and nausea. Each modality has a score between 0 and 3, and patients are considered dischargeable to the ward when the score sum of all criteria is four or less and no single score is above one. Sedation: 0 fully awake, 1, sleeping aroused by verbal stimuli, 2 sleeping, aroused by physical stimuli, 3 sleeping, cannot be aroused. Oxygen saturation (%): 0 ≥ 94, 1 90-93, 2 85-89, 3 \<85. Blood pressure, systolic (mmHg): 0 100-220, 1 90-99. 2 80-89 or \>220, 3\<80. Heart rate; pr. min: 0 50-100, 1 101-120, 2 40-49 or 121-130, 3 \<40 or \>130. Pain (at rest) (Numeric rating scale 0-10): 0 0, 1 0-2, 2 3-6, 3 ≥ 7 Nausea (patient evaluation and nurse observation): 0 none, 1 light, 2 moderate, 3 severe or vomiting.

Time frame: within 3 hours

ArmMeasureValue (MEDIAN)
Dexamethasone 8 mgDischarge Score, Arrival at Ward1 score on a scale
Dexamethasone 24 mgDischarge Score, Arrival at Ward1 score on a scale
Secondary

Discharge Score,(Modified Aldrete Discharge Score), Operating Room

Danish Society of Anesthesiology and Intensive Care Medicine (DASAIM) discharge score.Construct: The score consists of six modalities (subscores): Sedation,Oxygen saturation,blood pressure,heart rate,pain (at rest)and nausea.Each modality has a score between 0 and 3,and patients are considered dischargeable to the ward when the score sum of all criteria (total score) is 4 or less and no single score is above 1. All values (subscores) are considered best at 0 and worst at 3. Sedation: 0 fully awake, 1, sleeping aroused by verbal stimuli, 2 sleeping aroused by physical stimuli, 3 sleeping cannot be aroused. Oxygen saturation (%):0 ≥94, 1 90-93, 2 85-89, 3 \<85. Blood pressure, systolic (mmHg): 0 100-220, 1 90-99. 2 80-89 or \>220, 3\<80. Heart rate; pr. min: 0 50-100, 1 101-120, 2 40-49 or 121-130, 3 \<40 or \>130. Pain (at rest) (Numeric rating scale 0-10): 0 0, 1 0-2, 2 3-6, 3 ≥ 7 Nausea (patient evaluation and nurse observation): 0 none, 1 light, 2 moderate, 3 severe or vomiting.

Time frame: At transfer from operating room, within 1 hour post-surgery

ArmMeasureValue (MEDIAN)
Dexamethasone 8 mgDischarge Score,(Modified Aldrete Discharge Score), Operating Room0 score on a scale
Dexamethasone 24 mgDischarge Score,(Modified Aldrete Discharge Score), Operating Room1 score on a scale
p-value: 0.114Wilcoxon (Mann-Whitney)
Secondary

Mental Status

Self-reported feelings of restlessness, sadness and fatigue (days 0-4). Questionnaire (anwers possible: yes or no. Numbers are patients answering yes)

Time frame: days 0-4

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Dexamethasone 8 mgMental StatusDAY 4 : sadness14 Participants
Dexamethasone 8 mgMental StatusDAY 0 : fatigue26 Participants
Dexamethasone 8 mgMental StatusDAY 0 : restlessness17 Participants
Dexamethasone 8 mgMental StatusDAY 0 : sadness14 Participants
Dexamethasone 8 mgMental StatusDAY 1 : restlessness9 Participants
Dexamethasone 8 mgMental StatusDAY 1 : sadness13 Participants
Dexamethasone 8 mgMental StatusDAY 1 : fatigue11 Participants
Dexamethasone 8 mgMental StatusDAY 2 : restlessness14 Participants
Dexamethasone 8 mgMental StatusDAY 2 : sadness14 Participants
Dexamethasone 8 mgMental StatusDAY 2 : fatigue16 Participants
Dexamethasone 8 mgMental StatusDAY 3 : restlessness11 Participants
Dexamethasone 8 mgMental StatusDAY 3 : sadness14 Participants
Dexamethasone 8 mgMental StatusDAY 3 : fatigue14 Participants
Dexamethasone 8 mgMental StatusDAY 4 : restlessness13 Participants
Dexamethasone 8 mgMental StatusDAY 4 : fatigue14 Participants
Dexamethasone 24 mgMental StatusDAY 4 : sadness12 Participants
Dexamethasone 24 mgMental StatusDAY 2 : sadness18 Participants
Dexamethasone 24 mgMental StatusDAY 0 : fatigue28 Participants
Dexamethasone 24 mgMental StatusDAY 3 : fatigue17 Participants
Dexamethasone 24 mgMental StatusDAY 0 : restlessness20 Participants
Dexamethasone 24 mgMental StatusDAY 2 : fatigue17 Participants
Dexamethasone 24 mgMental StatusDAY 0 : sadness18 Participants
Dexamethasone 24 mgMental StatusDAY 4 : fatigue15 Participants
Dexamethasone 24 mgMental StatusDAY 1 : restlessness9 Participants
Dexamethasone 24 mgMental StatusDAY 3 : restlessness8 Participants
Dexamethasone 24 mgMental StatusDAY 1 : sadness13 Participants
Dexamethasone 24 mgMental StatusDAY 4 : restlessness13 Participants
Dexamethasone 24 mgMental StatusDAY 1 : fatigue27 Participants
Dexamethasone 24 mgMental StatusDAY 3 : sadness20 Participants
Dexamethasone 24 mgMental StatusDAY 2 : restlessness8 Participants
p-value: >0.003Chi-squared
Secondary

Number of Participants With Complication

complications requiring treatment until discharge

Time frame: 24 hours

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Dexamethasone 8 mgNumber of Participants With Complication12 Participants
Dexamethasone 24 mgNumber of Participants With Complication9 Participants
Secondary

Number of Participants With Seroma, Requiring Treatment

Seroma, requiring treatment the first 14 days.

Time frame: 14 days

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Dexamethasone 8 mgNumber of Participants With Seroma, Requiring Treatment51 Participants
Dexamethasone 24 mgNumber of Participants With Seroma, Requiring Treatment60 Participants
p-value: 0.0395% CI: [1.07, 11.6]Chi-squared
Secondary

Pain, Numeric Rating Scale

Self-reported pain (worst and average (average through that day), days 0-4) on a numeric rating scale (NRS) 0-10. 0 is no pain, 10 is worst pain imaginable.. Questionnaire.

Time frame: days 0-4

ArmMeasureGroupValue (MEDIAN)
Dexamethasone 8 mgPain, Numeric Rating ScaleDay 0, average2 score on a scale
Dexamethasone 8 mgPain, Numeric Rating ScaleDay 1, average2 score on a scale
Dexamethasone 8 mgPain, Numeric Rating ScaleDay 2, average1 score on a scale
Dexamethasone 8 mgPain, Numeric Rating ScaleDay 3, average1 score on a scale
Dexamethasone 8 mgPain, Numeric Rating ScaleDay 4, average1 score on a scale
Dexamethasone 8 mgPain, Numeric Rating ScaleDay 0, worst3 score on a scale
Dexamethasone 8 mgPain, Numeric Rating ScaleDay 1, worst2 score on a scale
Dexamethasone 8 mgPain, Numeric Rating ScaleDay 2, worst2 score on a scale
Dexamethasone 8 mgPain, Numeric Rating ScaleDay 3, worst1 score on a scale
Dexamethasone 8 mgPain, Numeric Rating ScaleDay 4, worst1 score on a scale
Dexamethasone 24 mgPain, Numeric Rating ScaleDay 2, worst2 score on a scale
Dexamethasone 24 mgPain, Numeric Rating ScaleDay 0, average2 score on a scale
Dexamethasone 24 mgPain, Numeric Rating ScaleDay 0, worst3 score on a scale
Dexamethasone 24 mgPain, Numeric Rating ScaleDay 1, average1 score on a scale
Dexamethasone 24 mgPain, Numeric Rating ScaleDay 4, worst1 score on a scale
Dexamethasone 24 mgPain, Numeric Rating ScaleDay 2, average1 score on a scale
Dexamethasone 24 mgPain, Numeric Rating ScaleDay 1, worst1.5 score on a scale
Dexamethasone 24 mgPain, Numeric Rating ScaleDay 3, average1 score on a scale
Dexamethasone 24 mgPain, Numeric Rating ScaleDay 3, worst1 score on a scale
Dexamethasone 24 mgPain, Numeric Rating ScaleDay 4, average1 score on a scale
p-value: >0.193Wilcoxon (Mann-Whitney)
Secondary

Post Operative Nausea and Vomiting (PONV).

Self-reported nausea, questionnaire, day 0-4. Number of participants reporting nausea and/or vomiting

Time frame: days 0-4

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Dexamethasone 8 mgPost Operative Nausea and Vomiting (PONV).DAY 16 Participants
Dexamethasone 8 mgPost Operative Nausea and Vomiting (PONV).DAY 37 Participants
Dexamethasone 8 mgPost Operative Nausea and Vomiting (PONV).DAY 26 Participants
Dexamethasone 8 mgPost Operative Nausea and Vomiting (PONV).DAY 47 Participants
Dexamethasone 8 mgPost Operative Nausea and Vomiting (PONV).DAY 06 Participants
Dexamethasone 24 mgPost Operative Nausea and Vomiting (PONV).DAY 46 Participants
Dexamethasone 24 mgPost Operative Nausea and Vomiting (PONV).DAY 011 Participants
Dexamethasone 24 mgPost Operative Nausea and Vomiting (PONV).DAY 110 Participants
Dexamethasone 24 mgPost Operative Nausea and Vomiting (PONV).DAY 29 Participants
Dexamethasone 24 mgPost Operative Nausea and Vomiting (PONV).DAY 36 Participants
p-value: >0.2Wilcoxon (Mann-Whitney)
Secondary

Quality of Sleep

Self-reported quality of sleep (days 0-4). Questionnaire. Dichotomized to Good sleep or sleep problems, numbers reported are number of patients with sleep problems

Time frame: days 0-4

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Dexamethasone 8 mgQuality of SleepDAY 120 Participants
Dexamethasone 8 mgQuality of SleepDAY 318 Participants
Dexamethasone 8 mgQuality of SleepDAY 224 Participants
Dexamethasone 8 mgQuality of SleepDAY 417 Participants
Dexamethasone 8 mgQuality of SleepDAY 031 Participants
Dexamethasone 24 mgQuality of SleepDAY 416 Participants
Dexamethasone 24 mgQuality of SleepDAY 039 Participants
Dexamethasone 24 mgQuality of SleepDAY 122 Participants
Dexamethasone 24 mgQuality of SleepDAY 218 Participants
Dexamethasone 24 mgQuality of SleepDAY 317 Participants
p-value: >0.136Chi-squared
Secondary

Readmission

Any readmission, days 0-30

Time frame: 30 days

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Dexamethasone 8 mgReadmission4 Participants
Dexamethasone 24 mgReadmission4 Participants
Secondary

Secondary Transfer

Secondary transfer to PACU from ward, or to intensive care unit from PACU

Time frame: 24-48 hours

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Dexamethasone 8 mgSecondary Transfer0 Participants
Dexamethasone 24 mgSecondary Transfer0 Participants
Secondary

Total Length of Stay in Hospital

Length of stay in hospital, measured from start of procedure to discharge from hospital to home

Time frame: 24-48 hours

ArmMeasureValue (MEDIAN)
Dexamethasone 8 mgTotal Length of Stay in Hospital9.2 hours
Dexamethasone 24 mgTotal Length of Stay in Hospital11 hours
p-value: 0.217Wilcoxon (Mann-Whitney)
Secondary

Total Length of Stay in PACU

Length of stay in the post-anesthesia care unit (PACU), measured as hours and minutes, from start of procedure, to discharge from PACU

Time frame: 12 hours

ArmMeasureValue (MEDIAN)
Dexamethasone 8 mgTotal Length of Stay in PACU1.5 hours
Dexamethasone 24 mgTotal Length of Stay in PACU1.5 hours
p-value: 0.35Wilcoxon (Mann-Whitney)

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026