Abstract | BACKGROUND: A single preoperative high dose of methylprednisolone (15 to 30 mg/kg) has been advocated in surgery, because it may inhibit the surgical stress response and thereby improve postoperative outcome and convalescence. However, these potential clinical benefits must be weighed against possible adverse effects. OBJECTIVE: To conduct a risk-benefit analysis using a meta-analysis, to compare complication rates and clinical advantages associated with the use of high dose methylprednisolone in surgical patients. METHODS: Randomised controlled trials of high dose methylprednisolone in elective and trauma surgery were systematically searched for in various literature databases. Outcome data on adverse effects, postoperative pain and hospital stay were extracted and statistically pooled in fixed-effects meta-analyses. RESULTS: We located 51 studies in elective cardiac and noncardiac surgery, as well as traumatology. Pooled data failed to show any significant increase in complication rates. In patients treated with corticosteroids, nonsignificantly more gastrointestinal bleeding and wound complications were observed; the 95% confidence interval boundaries of the numbers-needed-to-harm were 59 and 38, respectively. The only significant finding was a reduction of pulmonary complications (risk difference -3.5%; 95% confidence interval -1.0 to -6.1), mainly in trauma patients. CONCLUSION:
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Authors | S Sauerland, M Nagelschmidt, P Mallmann, E A Neugebauer |
Journal | Drug safety
(Drug Saf)
Vol. 23
Issue 5
Pg. 449-61
(Nov 2000)
ISSN: 0114-5916 [Print] New Zealand |
PMID | 11085349
(Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Systematic Review)
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Chemical References |
- Anti-Inflammatory Agents
- Methylprednisolone Hemisuccinate
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Topics |
- Animals
- Anti-Inflammatory Agents
(administration & dosage, adverse effects)
- Humans
- Methylprednisolone Hemisuccinate
(administration & dosage, adverse effects)
- Premedication
- Preoperative Care
- Randomized Controlled Trials as Topic
- Risk Assessment
- Treatment Outcome
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