Age-related Differences in the Efficacy of Dexamethasone for Postoperative Analgesia in Patients undergoing Laparoscopic Cholecystectomy: A randomised controlled study

Objective: This study aimed to investigate age-related differences in the effects of dexamethasone pre-treatment on pain intensity and morphine consumption in patients undergoing lap aroscopic cholecystectomy. Design: Randomized, prospective study Setting: Operating room of a Wonkwang university hospital, South Korea Subjects: Three hundred and eighty-eight patients undergoing laparoscopic cholecystectomy, 194 from a younger age group (18 - 45 years) and 194 from an older age group ( >= 65 years). Intervention: The patients within each group were randomly allocated into younger (normal saline/dexamethasone: 97/97) and older (97/97) groups. They received either intravenous dexamethasone 0.1 mg/kg or normal saline 1 hour before anaesthesia induction. Main outcome measures: The effect of dexamethasone on cumulative morphine-containing patient-controlled analgesia consumption, visual analogue scale scores for pain at 1, 2, 6, 12, and 24 hours after surgery, mean morphine consumption, and time to first rescue analgesia Results: When dexamethasone was administered, both age groups had significantly less cumulative patient-controlled analgesia consumption, mean morphine consumption, and longer time to first rescue analgesia. These effects were of greater magnitude in the older than in the younger group. Visual analogue scales for pain at 1, 6, and 12 hours after surgery was significantly higher in the younger group. Conclusion: The effects of dexamethasone on clinically relevant pain were greater in the older group, who experienced less post-operative pain. Further investigation regarding this association is warranted.