The efficacy and safety of perioperative administration of dexamethasone: a systematic review and meta-analysis

Abstract Background Perioperative prophylactic dexamethasone is commonly administered to reduce postoperative nausea and vomiting (PONV) and pain after surgery. In this study, we aimed to systematically review the efficacy and adverse effects of perioperative dexamethasone administration. Methods We conducted a systematic search until January 2023 in scientific databases, including PubMed, Scopus, Embase, Web of Science, and Google Scholar. After assessing the methodological quality of relevant studies, we synthesized those focusing on PONV, oral food intake tolerance, impaired wound healing, major postoperative complications, and postoperative infections following the perioperative administration of dexamethasone. Results A total of 27 studies were included in this systematic review and meta-analysis. The dexamethasone group showed decreased PONV (OR = 0.19; 95% CI 0.06–0.55), increased oral food intake tolerance (OR = 7.38; 95% CI 1.07–51.11), increased risk of impaired wound healing (OR = .48; 95% CI 0.52–4.21), decreased probability of postoperative infection (OR = 0.61; 95% CI 0.51–0.72), and increased risk of major postoperative complications (OR = 1.27; 95% CI 0.68–2.39) compared to the controls. Conclusions The results of our pooled data analysis showed that dexamethasone was superior to the control in terms of PONV, oral food intake tolerance, and postoperative infections.