The Effect of Preoperative Injectable Dexamethasone on Postoperative Pain Following Hysterectomy in Patients Hospitalized at Imam Hospital of Sari in 2024-2025
Abstract
Hysterectomy is one of the most common gynecological surgeries, recognized as the most frequently performed
gynecological surgical procedure worldwide (1, 2). The main reasons for performing this surgery include uterine
fibroids, abnormal uterine bleeding, and pelvic pain (2, 3). In Germany, 17.5% of women aged 18 to 79 have
experienced this surgery, with most cases occurring in the 40 to 49 age group (4). The prevalence of hysterectomy
in different countries is influenced by socio-economic factors and access to healthcare services (5). In Iran, the
number of hysterectomy operations in a university clinic in Tehran averaged 219 cases per year between 2005
and 2009, and most women were in the 45 to 54 age group.
1. Obikili C, Magaji F. An audit of hysterectomy at the Jos University Teaching Hospital, Jos, Plateau State, North Central Nigeria. Jos J Med. 2019;13(1):13-18.
2. Ali SA, Farahat MM, ElShafei MAM. Surgical approach to hysterectomy for benign gynecological diseases. Egypt J Hosp Med. 2019;77(3):5279-5286. https://doi.org/10.21608/ejhm.2019.55490
3. Shamsunnahar D, Rashid D, Naower DR. Non-Descent Vaginal Hysterectomy Versus Laparoscopic Hysterectomy; A Comparative Analysis Based on A Hospital in Bangladesh. ARC J Gynecol Obstet. 2023;7:11-15. https://doi.org/10.20431/2456-0561.0701002
4. Prütz F, Knopf H, von der Lippe E, Scheidt-Nave C, Starker A, Fuchs J. Prävalenz von Hysterektomien bei Frauen im Alter von 18 bis 79 Jahren. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013;56(5):716-722. https://doi.org/10.1007/s00103-012-1660-7
5. Gartner DR, Doll KM, Hummer RA, Robinson WR. Contemporary geographic variation and socio-demographic correlates of hysterectomy rates among reproductive aged women. South Med J. 2018;111(10):585-591. https://doi.org/10.14423/SMJ.0000000000000870
6. Khaniki M, Shojaie M, Tarafdari AM. Histopathological study of hysterectomy operations in a University clinic in Tehran from 2005 to 2009. Tehran Univ Med J. 2011;69(5):312-318.
7. Soares TV, Lassala JR, Alencar JLG, Costa GR, Egito IA, Hupp MVS, et al. Histerectomia: Uma análise abrange sob a ótica cirúrgica. Braz J Implant Health Sci. 2024;6(9):1551-1561. https://doi.org/10.36557/2674-8169.2024v6n9p1551-1561
8. Gnanarathne S. Non-descent vaginal hysterectomies: a brief report. Anuradhapura Med J. 2024;18(1):25-28. https://doi.org/10.4038/amj.v18i1.7812
9. Torpy J, Lynm C, Glass RM. JAMA patient page. Hypertensive kidney disease. JAMA. 2002;288(19):2498. https://doi.org/10.1001/jama.288.19.2498
10. de Costa C. Hysterectomy. Med J Aust. 1992;157(10):707-708. https://doi.org/10.5694/j.1326-5377.1992.tb137444.x
11. Hensel M, Frenzel J, Späker M, Keil E, Reinhold N. Postoperative Schmerztherapie nach minimalinvasiver Hysterektomie. Anaesthesist. 2013;62(10):797-807. https://doi.org/10.1007/s00101-013-2234-2
12. Kantarcı S, Karabulut A, Dağlı U, Yetimoğlu E, İleri A, İnan AH. Early Emergency Visits After Laparoscopic Hysterectomy: Risk Factors and Prevention. JSLS. 2025;29(3):e2025.00066. https://doi.org/10.4293/JSLS.2025.00066
13. Park SI, Ko YK, Yoon HS, Yoon SH, Lee WH, Lee JU. Analysis of Factors related to Postoperative Nausea and Vomiting after Laparoscopic Hysterectomy. Korean J Anesthesiol. 2005;49(2):210-215. https://doi.org/10.4097/kjae.2005.49.2.210
14. Kurçaloğlu M, Önal M, Yaşar C, Yilmazlar F, Uslu PU, Yoleri Y. Comparison of postoperative pain rates with different hysterectomy techniques: A retrospective study. Medicine (Baltimore). 2025;104(36):e44374. https://doi.org/10.1097/MD.0000000000044374
15. Wodlin NB. Risk factors for impaired patient-reported satisfaction and increased length of hospital stay following hysterectomy on benign indications in premenopausal women: a study from the Swedish National Register for gynecological surgery. Geburtshilfe Frauenheilkd. 2020;80(3):288-299. https://doi.org/10.1055/a-1005-0039
16. Rongtonggul R, Yoosuk W, Tharnprisan P, Bungrathok B, Thienthong S. A prospective Pain Survey in the Second Postoperative Day after Total Abdominal Hysterectomy. Srinagarind Med J. 2005;20(4):215-221.
17. Jin J, Min S, Peng L, Du X, Zhang D, Ren L. No differences in the prevalence and intensity of chronic postsurgical pain between laparoscopic hysterectomy and abdominal hysterectomy: a prospective study. J Pain Res. 2020;13:1-9. https://doi.org/10.2147/JPR.S225230
18. Lakhno I, Korovai S, Zheleznyakov O, Novikova O. Abdominal hysterectomy and postoperative quality of recovery: emphasis on pain relief. Pain Med. 2022;7(3):15-19. https://doi.org/10.31636/pmjua.v7i3.3
19. Arbel R, Stanleigh J, Ioscovich A. Pain management following abdominal hysterectomy: novel approaches and review of the literature. J Clin Gynecol Obstet. 2013;2(2):51-55. https://doi.org/10.4021/jcgo130w
20. White KD, Azadi S, Pauley A, Mitchell DBL, Bou Zgheib N. Reducing postoperative opioids after minimally invasive hysterectomy with enhanced recovery. Marshall J Med. 2019;5(1):50-69. https://doi.org/10.33470/2379-9536.1209
21. Martins EM, Girola C, Wolpe RE, Da Roza TH, Honório GJDS. Physiotherapeutic approach in women undergoing hysterectomy. Man Ther Posturol Rehabil J. 2020;18:1-10. https://doi.org/10.17784/mtprehabjournal.2020.18.785
22. Arunashreya D, Madhumitha D, Akshara D. A review on postoperative pain relief in women undergoing abdominal hysterectomy. Int J Med Anesthesiol. 2022;5(3):33-36. https://doi.org/10.33545/26643766.2022.v5.i3a.359
23. Hensel M, Frenzel J, Späker M, Keil E, Reinhold N. Postoperative pain management after minimally invasive hysterectomy: thoracic epidural analgesia versus intravenous patient-controlled analgesia. Anaesthesist. 2013;62(10):797-807. https://doi.org/10.1007/s00101-013-2234-2
24. Li X, Yu L, Yang J, Fu M, Tan H. Efficacy of preoperative single-dose dexamethasone in preventing postoperative pulmonary complications following minimally invasive esophagectomy: a retrospective propensity score-matched study. Perioper Med (Lond). 2024;13(1):46. https://doi.org/10.1186/s13741-024-00407-6
25. Cortés-Flores A, Jiménez-Tornero J, Morgan-Villela G, Delgado-Gómez M, Zuloaga-Fernández Del Valle C, García-Rentería J, et al. Effects of preoperative dexamethasone on postoperative pain, nausea, vomiting and respiratory function in women undergoing conservative breast surgery for cancer: results of a controlled clinical trial. Eur J Cancer Care (Engl). 2018;27(1):e12686. https://doi.org/10.1111/ecc.12686
26. Schietroma M, Cecilia EM, Carlei F, Sista F, De Santis G, Lancione L, et al. Dexamethasone for the prevention of recurrent laryngeal nerve palsy and other complications after thyroid surgery: a randomized double-blind placebo-controlled trial. JAMA Otolaryngol Head Neck Surg. 2013;139(5):471-478. https://doi.org/10.1001/jamaoto.2013.2821
27. Cihoric M, Kehlet H, Lauritsen ML, Højlund J, Kanstrup K, Kärnsund S, et al. Preoperative high dose of dexamethasone in emergency laparotomy: randomized clinical trial. Br J Surg. 2024;111(7):znae130. https://doi.org/10.1093/bjs/znae130
28. Kaiser K, Valsamidis AN, Karstensen SH, Strøm T, Gögenur I, Balsevicius L, et al. Effect of 24 mg dexamethasone preoperatively on surgical stress, pain and recovery in robotic-assisted laparoscopic hysterectomy. Contemp Clin Trials Commun. 2023;33:101109. https://doi.org/10.1016/j.conctc.2023.101109
29. Nikhade R, Gadkari C, Singh P, Warnekar D, Bhure A. Study of Efficacy of Dexamethasone as Preemptive Analgesic in Patients Undergoing Total Abdominal Hysterectomy Under Spinal Anaesthesia: A Randomised Controlled Trial. J Popul Ther Clin Pharmacol. 2024.
30. Thangaswamy CR, Rewari V, Trikha A, Dehran M, Chandralekha. Dexamethasone before total laparoscopic hysterectomy: a randomized controlled dose-response study. J Anesth. 2010;24(1):24-30. https://doi.org/10.1007/s00540-009-0830-8
31. De Oliveira GS Jr, Ahmad S, Fitzgerald P, Marcus R, Altman C, Panjwani A, et al. Dose ranging study on the effect of preoperative dexamethasone on postoperative quality of recovery and opioid consumption after ambulatory gynaecological surgery. Br J Anaesth. 2011;107(3):362-371. https://doi.org/10.1093/bja/aer156
32. Shetabi H, Adinehmehr L, Salehi-Cheliche Z. A comparative study of the effect of intranasal dexamethasone and normal saline on the occurrence of nausea and vomiting after hysterectomy: A clinical trial study. Med J Tabriz Univ Med Sci. 2023;44(6):500-510. https://doi.org/10.34172/mj.2023.004
33. Murphy GS, Szokol JW, Greenberg SB, Avram MJ, Vender JS, Nisman M, et al. Preoperative dexamethasone enhances quality of recovery after laparoscopic cholecystectomy: effect on in-hospital and postdischarge recovery outcomes. Anesthesiology. 2011;114(4):882-890. https://doi.org/10.1097/ALN.0b013e3181ec642e
34. Corcoran TB, Martin C, O’Loughlin E, Ho K, Chan M, Forbes A, et al. Dexamethasone and persistent wound pain: a prespecified analysis of the randomised Perioperative Administration of Dexamethasone and Infection (PADDI) trial. Br J Anaesth. 2023;131(1):93-103. https://doi.org/10.1016/j.bja.2023.03.031
35. Liu XY, Mou P, Cao J, Wang HY, Zeng WN, Zhou ZK. Effects of dexamethasone on postoperative glycemic control in patients after primary total joint arthroplasty: a randomized double-blind controlled trial. J Arthroplasty. 2024;39(9):2213-2220. https://doi.org/10.1016/j.arth.2024.04.030
36. Turan A, Sessler DI. Steroids to ameliorate postoperative pain. Anesthesiology. 2011;115(3):457-459. https://doi.org/10.1097/ALN.0b013e31822a2871
37. Jamwal D, Sharma D, Jamwal D. Study of efficacy of dexamethasone as preemptive analgesic in patients undergoing total abdominal hysterectomy under spinal anaesthesia: prospective observational study. J Popul Ther Clin Pharmacol. 2024. https://doi.org/10.53555/jptcp.v31i4.5528
38. Waldron N, Jones C, Gan T, Allen T, Habib A. Impact of perioperative dexamethasone on postoperative analgesia and side-effects: systematic review and meta-analysis. Br J Anaesth. 2013;110(2):191-200. https://doi.org/10.1093/bja/aes431
39. De Oliveira GS, Almeida MD, Benzon HT, McCarthy RJ. Perioperative single dose systemic dexamethasone for postoperative pain: a meta-analysis of randomized controlled trials. Anesthesiology. 2011;115(3):575-588. https://doi.org/10.1097/ALN.0b013e31822a24c2
40. Mitchell C, Cheuk S, O’Donnell C, Bampoe S, Walker D. What is the impact of dexamethasone on postoperative pain in adults undergoing general anaesthesia for elective abdominal surgery: a systematic review and meta-analysis. Perioper Med (Lond). 2022;11(1):13. https://doi.org/10.1186/s13741-022-00243-6
41. Jamali S, Sabermoghaddam M, Sabermoghaddam A, Kiarudi M, Bakhtiari E. The Effect of Topical Dexamethasone on Postoperative Pain Intensity in Patients Undergoing Dacryocystorhinostomy Procedure. J Babol Univ Med Sci. 2023;25(1):78-87.
42. Farzi F, Sobhani A, Keshtkar A. Effect of Dexamethasone Before Induction of Anesthesia On Postoperative Shivering. J Guilan Univ Med Sci. 2001;10(39):42-49.
43. Jamil K, Qaisar R. The Effect of Dexamethasone on Postoperative Pain in Patients After Laparoscopic Cholecystectomy. Cureus. 2022;14(11):e32067. https://doi.org/10.7759/cureus.32067
44. Woo JH, Lee HJ, Oh HW, Lee JW, Baik HJ, Kim YJ. Perineural dexamethasone reduces rebound pain after ropivacaine single injection interscalene block for arthroscopic shoulder surgery: a randomized controlled trial. Reg Anesth Pain Med. 2021;46(11):965-970. https://doi.org/10.1136/rapm-2021-102795
45. Wanithanont P, Chaiyasamut T, Vongsavan K, Bhattarai BP, Pairuchvej V, Kiattavorncharoen S, et al. Comparative efficiency of the preoperative pterygomandibular space injection of two doses of dexamethasone in mandibular third molar surgery. J Dent Anesth Pain Med. 2021;21(1):29-39. https://doi.org/10.17245/jdapm.2021.21.1.29
46. Nielsen RV, Siegel H, Fomsgaard JS, Andersen JD, Martusevicius R, Mathiesen O, et al. Preoperative dexamethasone reduces acute but not sustained pain after lumbar disk surgery: a randomized, blinded, placebo-controlled trial. Pain. 2015;156(12):2538-2544. https://doi.org/10.1097/j.pain.0000000000000326
47. Fukami Y, Terasaki M, Okamoto Y, Sakaguchi K, Murata T, Ohkubo M, et al. Efficacy of preoperative dexamethasone in patients with laparoscopic cholecystectomy: a prospective randomized double-blind study. J Hepatobiliary Pancreat Surg. 2009;16(3):367-371. https://doi.org/10.1007/s00534-009-0079-5
48. Datta M. Preoperative Single Dose Dexamethasone Effectively Diminishes Postoperative Pain after Laparoscopic Surgery. J Clin Diagn Res. 2020.
49. Küçüksaraç G, Arslan KR, Sahin AS, Arslan K. Effect of Dexamethasone on Postoperative Analgesia Following the Transversus Abdominis Plane Block in Gynecological Laparotomies. Cureus. 2024;16(11):e73356. https://doi.org/10.7759/cureus.73814
50. Parihar A, Shukla N, Saxena A, Nigam S. Comparison of Post Operative Analgesic Efficacy of Dexamethasone as an Adjuvant with Ropivacaine 0.25% and Plain Ropivacaine 0.25%, Using Ultrasound Guided Tap Block after Total Abdominal Hysterectomy: A Randomized Controlled Trial. Acta Med Int. 2024;11(1):27-31. https://doi.org/10.4103/amit.amit_85_23
51. Roy S, Datta S. Effect of intravenous dexamethasone on spinal anaesthesia with bupivacaine plus fentanyl in patients undergoing vaginal hysterectomy. Age (yr). 2017;46(4.1):45.6-3.8.
52. Jokela RM, Ahonen JV, Tallgren MK, Marjakangas PC, Korttila KT. The effective analgesic dose of dexamethasone after laparoscopic hysterectomy. Anesth Analg. 2009;109(2):607-615. https://doi.org/10.1213/ane.0b013e3181ac0f5c
53. Corcoran T, Kasza J, Short T, O’loughlin E, Chan M, Leslie K, et al. Intraoperative dexamethasone does not increase the risk of postoperative wound infection: a propensity score-matched post hoc analysis of the ENIGMA-II trial (EnDEX). Br J Anaesth. 2017;118(2):190-199. https://doi.org/10.1093/bja/aew446
54. Ismael H, Horst M, Farooq M, Jordon J, Patton JH, Rubinfeld IS. Adverse effects of preoperative steroid use on surgical outcomes. Am J Surg. 2011;201(3):305-309. https://doi.org/10.1016/j.amjsurg.2010.09.018
55. Samimi SS, Bastanhagh E, Mohammadi S, Shariat MR, Pourfakhr P, Smith J. Hyperglycemic Response of Non-diabetic Women Undergoing Abdominal Hysterectomy Who Have Received Prophylactic Dexamethasone to Alleviate Nausea and Vomiting. Anesth Pain Med. 2020;10(5):e107893.
56. Sekhavat L, Davar R, Behdad S. Efficacy of prophylactic dexamethasone in prevention of postoperative nausea and vomiting. J Epidemiol Glob Health. 2015;5(2):175-179. https://doi.org/10.1016/j.jegh.2014.07.004
57. Sharma AN, Shankaranarayana P. Postoperative nausea and vomiting: palonosetron with dexamethasone vs. ondansetron with dexamethasone in laparoscopic hysterectomies. Oman Med J. 2015;30(4):252-256. https://doi.org/10.5001/omj.2015.51
58. Fujii Y. Reduction of Postoperative Nausea and Vomiting and Analgesic Requirement with Dexamethasone in Women Undergoing General Anesthesia for Mastectomy. J Clin Anesth. 2007;13(7):564-568. https://doi.org/10.1111/j.1524-4741.2007.00497.x
59. Dick W, am Esch JS. Prophylaxe von postoperativer Übelkeit und postoperativem Erbrechen. Anasthesiol Intensivmed Notfallmed Schmerzther. 1997;32(10):616-621. https://doi.org/10.1055/s-2007-995117
60. Gan TJ, Coop A, Philip BK, Group KS. A randomized, double-blind study of granisetron plus dexamethasone versus ondansetron plus dexamethasone to prevent postoperative nausea and vomiting in patients undergoing abdominal hysterectomy. Anesth Analg. 2005;101(5):1323-1329. https://doi.org/10.1213/01.ANE.0000180366.65267.F6
61. Corcoran TB, Martin C, O’Loughlin E, Ho KM, Coutts P, Chan MT, et al. Dexamethasone and clinically significant postoperative nausea and vomiting: a prespecified substudy of the randomised perioperative administration of dexamethasone and infection (PADDI) trial. Br J Anaesth. 2022;129(3):327-335. https://doi.org/10.1016/j.bja.2022.05.018
62. Apfel CC, Korttila K, Abdalla M, Kerger H, Turan A, Vedder I, et al. A factorial trial of six interventions for the prevention of postoperative nausea and vomiting. N Engl J Med. 2004;350(24):2441-2451. https://doi.org/10.1056/NEJMoa032196
63. Li G, Lv Y, Gao S, Yao X, Ren S, Dong L, et al. Esketamine/dexmedetomidine-based opioid-free anesthesia and its association with postoperative bowel and cognitive dysfunction after total laparoscopic hysterectomy. BMC Anesthesiol. 2025;25(1):422. https://doi.org/10.1186/s12871-025-03301-w
64. Ramirez NL, Barba N, Flores E, Gracia-Filion P, Mahnert N. Opioid use and postoperative pain after hysterectomy. Am J Obstet Gynecol. 2024;230(4):S1271-S1273. https://doi.org/10.1016/j.ajog.2024.02.196
65. Bougie O, Blom J, Zhou G, Murji A, Thurston J. Use and misuse of opioid after gynecologic surgery. Best Pract Res Clin Obstet Gynaecol. 2022;85:23-34. https://doi.org/10.1016/j.bpobgyn.2022.07.005
66. Madsen AM, Martin JM, Linder BJ, Gebhart JB. Perioperative opioid management for minimally invasive hysterectomy. Best Pract Res Clin Obstet Gynaecol. 2022;85:68-80. https://doi.org/10.1016/j.bpobgyn.2022.05.006
67. Ready LB, Chadwick H, Ross B. Age predicts effective epidural morphine dose after abdominal hysterectomy. Anesth Analg. 1987;66(12):1215-1218. https://doi.org/10.1213/00000539-198712000-00002
68. Jno-Baptiste B, Scarlett MD, Harding HE. The effect of dexamethasone on postoperative opioid requirement in patients who underwent gynecology surgery at the university hospital in Jamaica. J Anesth Clin Res. 2014;5(470):2.
69. Lloret-Linares C, Lopes A, Declèves X, Serrie A, Mouly S, Bergmann JF, et al. Challenges in the optimisation of post-operative pain management with opioids in obese patients: a literature review. Obes Surg. 2013;23(9):1458-1475. https://doi.org/10.1007/s11695-013-0998-8
70. Laconi G, Coppens S, Roofthooft E, Van De Velde M. High dose glucocorticoids for treatment of postoperative pain: A systematic review of the literature and meta-analysis. J Clin Anesth. 2024;93:111352. https://doi.org/10.1016/j.jclinane.2023.111352
71. Yang C, Li Y, Hu J, Wu J, Huang S. The relationship between pre-operative glycosylated haemoglobin and opioid consumption after caesarean section in women with gestational diabetes mellitus. Front Endocrinol (Lausanne). 2022;13:910914. https://doi.org/10.3389/fendo.2022.910914
72. Setji TL, Gilmore L, Freeman S. Perioperative diabetes management. Diabetes Manag. 2018;8:67-73.
73. Andres S, Shu MK, Kent A, Greenberg D, Danakas G. Multimodal pain management after robotic-assisted total laparoscopic hysterectomy reduces postoperative opioid use and pain scores. Am J Obstet Gynecol. 2023;228(6):S1180. https://doi.org/10.1016/j.ygyno.2023.06.100
74. Corcoran TB, O’Loughlin E, Chan MT, Ho KM. Perioperative ADministration of Dexamethasone And blood Glucose concentrations in patients undergoing elective non-cardiac surgery-the randomised controlled PADDAG trial. Eur J Anaesthesiol. 2021;38(9):932-942. https://doi.org/10.1097/EJA.0000000000001294
75. Jones IA, LoBasso MA, Wier J, Gettleman BS, Richardson MK, Ratto CE, et al. Perioperative dexamethasone in diabetic patients: a systematic review and meta-analysis of randomized, placebo-controlled trials. Anesth Analg. 2024;139(3):479-489. https://doi.org/10.1213/ANE.0000000000007007
76. Qi M, Xiao W, Yang S, Wang S, Zhou L, Wan A, et al. Pre-Incisional preventive precise Multimodal analgesia may enhance the rehabilitation process of acute postoperative pain following total Laparoscopic hysterectomy: A randomized controlled trial. Pain Physician. 2023;26(3):E123-E133. https://doi.org/10.36076/ppj.2023.26.E123
77. Shanmugasundaram S, SK B, Kumar CA, Periaswamy P. Comparative Analysis of Epidural Dexamethasone and Epidural Morphine for Postoperative Pain Control After Total Abdominal Hysterectomy: A Randomized Clinical Trial. J Cell Mol Anesth. 2024;9(3):1-8. https://doi.org/10.5812/jcma-146995
2. Ali SA, Farahat MM, ElShafei MAM. Surgical approach to hysterectomy for benign gynecological diseases. Egypt J Hosp Med. 2019;77(3):5279-5286. https://doi.org/10.21608/ejhm.2019.55490
3. Shamsunnahar D, Rashid D, Naower DR. Non-Descent Vaginal Hysterectomy Versus Laparoscopic Hysterectomy; A Comparative Analysis Based on A Hospital in Bangladesh. ARC J Gynecol Obstet. 2023;7:11-15. https://doi.org/10.20431/2456-0561.0701002
4. Prütz F, Knopf H, von der Lippe E, Scheidt-Nave C, Starker A, Fuchs J. Prävalenz von Hysterektomien bei Frauen im Alter von 18 bis 79 Jahren. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013;56(5):716-722. https://doi.org/10.1007/s00103-012-1660-7
5. Gartner DR, Doll KM, Hummer RA, Robinson WR. Contemporary geographic variation and socio-demographic correlates of hysterectomy rates among reproductive aged women. South Med J. 2018;111(10):585-591. https://doi.org/10.14423/SMJ.0000000000000870
6. Khaniki M, Shojaie M, Tarafdari AM. Histopathological study of hysterectomy operations in a University clinic in Tehran from 2005 to 2009. Tehran Univ Med J. 2011;69(5):312-318.
7. Soares TV, Lassala JR, Alencar JLG, Costa GR, Egito IA, Hupp MVS, et al. Histerectomia: Uma análise abrange sob a ótica cirúrgica. Braz J Implant Health Sci. 2024;6(9):1551-1561. https://doi.org/10.36557/2674-8169.2024v6n9p1551-1561
8. Gnanarathne S. Non-descent vaginal hysterectomies: a brief report. Anuradhapura Med J. 2024;18(1):25-28. https://doi.org/10.4038/amj.v18i1.7812
9. Torpy J, Lynm C, Glass RM. JAMA patient page. Hypertensive kidney disease. JAMA. 2002;288(19):2498. https://doi.org/10.1001/jama.288.19.2498
10. de Costa C. Hysterectomy. Med J Aust. 1992;157(10):707-708. https://doi.org/10.5694/j.1326-5377.1992.tb137444.x
11. Hensel M, Frenzel J, Späker M, Keil E, Reinhold N. Postoperative Schmerztherapie nach minimalinvasiver Hysterektomie. Anaesthesist. 2013;62(10):797-807. https://doi.org/10.1007/s00101-013-2234-2
12. Kantarcı S, Karabulut A, Dağlı U, Yetimoğlu E, İleri A, İnan AH. Early Emergency Visits After Laparoscopic Hysterectomy: Risk Factors and Prevention. JSLS. 2025;29(3):e2025.00066. https://doi.org/10.4293/JSLS.2025.00066
13. Park SI, Ko YK, Yoon HS, Yoon SH, Lee WH, Lee JU. Analysis of Factors related to Postoperative Nausea and Vomiting after Laparoscopic Hysterectomy. Korean J Anesthesiol. 2005;49(2):210-215. https://doi.org/10.4097/kjae.2005.49.2.210
14. Kurçaloğlu M, Önal M, Yaşar C, Yilmazlar F, Uslu PU, Yoleri Y. Comparison of postoperative pain rates with different hysterectomy techniques: A retrospective study. Medicine (Baltimore). 2025;104(36):e44374. https://doi.org/10.1097/MD.0000000000044374
15. Wodlin NB. Risk factors for impaired patient-reported satisfaction and increased length of hospital stay following hysterectomy on benign indications in premenopausal women: a study from the Swedish National Register for gynecological surgery. Geburtshilfe Frauenheilkd. 2020;80(3):288-299. https://doi.org/10.1055/a-1005-0039
16. Rongtonggul R, Yoosuk W, Tharnprisan P, Bungrathok B, Thienthong S. A prospective Pain Survey in the Second Postoperative Day after Total Abdominal Hysterectomy. Srinagarind Med J. 2005;20(4):215-221.
17. Jin J, Min S, Peng L, Du X, Zhang D, Ren L. No differences in the prevalence and intensity of chronic postsurgical pain between laparoscopic hysterectomy and abdominal hysterectomy: a prospective study. J Pain Res. 2020;13:1-9. https://doi.org/10.2147/JPR.S225230
18. Lakhno I, Korovai S, Zheleznyakov O, Novikova O. Abdominal hysterectomy and postoperative quality of recovery: emphasis on pain relief. Pain Med. 2022;7(3):15-19. https://doi.org/10.31636/pmjua.v7i3.3
19. Arbel R, Stanleigh J, Ioscovich A. Pain management following abdominal hysterectomy: novel approaches and review of the literature. J Clin Gynecol Obstet. 2013;2(2):51-55. https://doi.org/10.4021/jcgo130w
20. White KD, Azadi S, Pauley A, Mitchell DBL, Bou Zgheib N. Reducing postoperative opioids after minimally invasive hysterectomy with enhanced recovery. Marshall J Med. 2019;5(1):50-69. https://doi.org/10.33470/2379-9536.1209
21. Martins EM, Girola C, Wolpe RE, Da Roza TH, Honório GJDS. Physiotherapeutic approach in women undergoing hysterectomy. Man Ther Posturol Rehabil J. 2020;18:1-10. https://doi.org/10.17784/mtprehabjournal.2020.18.785
22. Arunashreya D, Madhumitha D, Akshara D. A review on postoperative pain relief in women undergoing abdominal hysterectomy. Int J Med Anesthesiol. 2022;5(3):33-36. https://doi.org/10.33545/26643766.2022.v5.i3a.359
23. Hensel M, Frenzel J, Späker M, Keil E, Reinhold N. Postoperative pain management after minimally invasive hysterectomy: thoracic epidural analgesia versus intravenous patient-controlled analgesia. Anaesthesist. 2013;62(10):797-807. https://doi.org/10.1007/s00101-013-2234-2
24. Li X, Yu L, Yang J, Fu M, Tan H. Efficacy of preoperative single-dose dexamethasone in preventing postoperative pulmonary complications following minimally invasive esophagectomy: a retrospective propensity score-matched study. Perioper Med (Lond). 2024;13(1):46. https://doi.org/10.1186/s13741-024-00407-6
25. Cortés-Flores A, Jiménez-Tornero J, Morgan-Villela G, Delgado-Gómez M, Zuloaga-Fernández Del Valle C, García-Rentería J, et al. Effects of preoperative dexamethasone on postoperative pain, nausea, vomiting and respiratory function in women undergoing conservative breast surgery for cancer: results of a controlled clinical trial. Eur J Cancer Care (Engl). 2018;27(1):e12686. https://doi.org/10.1111/ecc.12686
26. Schietroma M, Cecilia EM, Carlei F, Sista F, De Santis G, Lancione L, et al. Dexamethasone for the prevention of recurrent laryngeal nerve palsy and other complications after thyroid surgery: a randomized double-blind placebo-controlled trial. JAMA Otolaryngol Head Neck Surg. 2013;139(5):471-478. https://doi.org/10.1001/jamaoto.2013.2821
27. Cihoric M, Kehlet H, Lauritsen ML, Højlund J, Kanstrup K, Kärnsund S, et al. Preoperative high dose of dexamethasone in emergency laparotomy: randomized clinical trial. Br J Surg. 2024;111(7):znae130. https://doi.org/10.1093/bjs/znae130
28. Kaiser K, Valsamidis AN, Karstensen SH, Strøm T, Gögenur I, Balsevicius L, et al. Effect of 24 mg dexamethasone preoperatively on surgical stress, pain and recovery in robotic-assisted laparoscopic hysterectomy. Contemp Clin Trials Commun. 2023;33:101109. https://doi.org/10.1016/j.conctc.2023.101109
29. Nikhade R, Gadkari C, Singh P, Warnekar D, Bhure A. Study of Efficacy of Dexamethasone as Preemptive Analgesic in Patients Undergoing Total Abdominal Hysterectomy Under Spinal Anaesthesia: A Randomised Controlled Trial. J Popul Ther Clin Pharmacol. 2024.
30. Thangaswamy CR, Rewari V, Trikha A, Dehran M, Chandralekha. Dexamethasone before total laparoscopic hysterectomy: a randomized controlled dose-response study. J Anesth. 2010;24(1):24-30. https://doi.org/10.1007/s00540-009-0830-8
31. De Oliveira GS Jr, Ahmad S, Fitzgerald P, Marcus R, Altman C, Panjwani A, et al. Dose ranging study on the effect of preoperative dexamethasone on postoperative quality of recovery and opioid consumption after ambulatory gynaecological surgery. Br J Anaesth. 2011;107(3):362-371. https://doi.org/10.1093/bja/aer156
32. Shetabi H, Adinehmehr L, Salehi-Cheliche Z. A comparative study of the effect of intranasal dexamethasone and normal saline on the occurrence of nausea and vomiting after hysterectomy: A clinical trial study. Med J Tabriz Univ Med Sci. 2023;44(6):500-510. https://doi.org/10.34172/mj.2023.004
33. Murphy GS, Szokol JW, Greenberg SB, Avram MJ, Vender JS, Nisman M, et al. Preoperative dexamethasone enhances quality of recovery after laparoscopic cholecystectomy: effect on in-hospital and postdischarge recovery outcomes. Anesthesiology. 2011;114(4):882-890. https://doi.org/10.1097/ALN.0b013e3181ec642e
34. Corcoran TB, Martin C, O’Loughlin E, Ho K, Chan M, Forbes A, et al. Dexamethasone and persistent wound pain: a prespecified analysis of the randomised Perioperative Administration of Dexamethasone and Infection (PADDI) trial. Br J Anaesth. 2023;131(1):93-103. https://doi.org/10.1016/j.bja.2023.03.031
35. Liu XY, Mou P, Cao J, Wang HY, Zeng WN, Zhou ZK. Effects of dexamethasone on postoperative glycemic control in patients after primary total joint arthroplasty: a randomized double-blind controlled trial. J Arthroplasty. 2024;39(9):2213-2220. https://doi.org/10.1016/j.arth.2024.04.030
36. Turan A, Sessler DI. Steroids to ameliorate postoperative pain. Anesthesiology. 2011;115(3):457-459. https://doi.org/10.1097/ALN.0b013e31822a2871
37. Jamwal D, Sharma D, Jamwal D. Study of efficacy of dexamethasone as preemptive analgesic in patients undergoing total abdominal hysterectomy under spinal anaesthesia: prospective observational study. J Popul Ther Clin Pharmacol. 2024. https://doi.org/10.53555/jptcp.v31i4.5528
38. Waldron N, Jones C, Gan T, Allen T, Habib A. Impact of perioperative dexamethasone on postoperative analgesia and side-effects: systematic review and meta-analysis. Br J Anaesth. 2013;110(2):191-200. https://doi.org/10.1093/bja/aes431
39. De Oliveira GS, Almeida MD, Benzon HT, McCarthy RJ. Perioperative single dose systemic dexamethasone for postoperative pain: a meta-analysis of randomized controlled trials. Anesthesiology. 2011;115(3):575-588. https://doi.org/10.1097/ALN.0b013e31822a24c2
40. Mitchell C, Cheuk S, O’Donnell C, Bampoe S, Walker D. What is the impact of dexamethasone on postoperative pain in adults undergoing general anaesthesia for elective abdominal surgery: a systematic review and meta-analysis. Perioper Med (Lond). 2022;11(1):13. https://doi.org/10.1186/s13741-022-00243-6
41. Jamali S, Sabermoghaddam M, Sabermoghaddam A, Kiarudi M, Bakhtiari E. The Effect of Topical Dexamethasone on Postoperative Pain Intensity in Patients Undergoing Dacryocystorhinostomy Procedure. J Babol Univ Med Sci. 2023;25(1):78-87.
42. Farzi F, Sobhani A, Keshtkar A. Effect of Dexamethasone Before Induction of Anesthesia On Postoperative Shivering. J Guilan Univ Med Sci. 2001;10(39):42-49.
43. Jamil K, Qaisar R. The Effect of Dexamethasone on Postoperative Pain in Patients After Laparoscopic Cholecystectomy. Cureus. 2022;14(11):e32067. https://doi.org/10.7759/cureus.32067
44. Woo JH, Lee HJ, Oh HW, Lee JW, Baik HJ, Kim YJ. Perineural dexamethasone reduces rebound pain after ropivacaine single injection interscalene block for arthroscopic shoulder surgery: a randomized controlled trial. Reg Anesth Pain Med. 2021;46(11):965-970. https://doi.org/10.1136/rapm-2021-102795
45. Wanithanont P, Chaiyasamut T, Vongsavan K, Bhattarai BP, Pairuchvej V, Kiattavorncharoen S, et al. Comparative efficiency of the preoperative pterygomandibular space injection of two doses of dexamethasone in mandibular third molar surgery. J Dent Anesth Pain Med. 2021;21(1):29-39. https://doi.org/10.17245/jdapm.2021.21.1.29
46. Nielsen RV, Siegel H, Fomsgaard JS, Andersen JD, Martusevicius R, Mathiesen O, et al. Preoperative dexamethasone reduces acute but not sustained pain after lumbar disk surgery: a randomized, blinded, placebo-controlled trial. Pain. 2015;156(12):2538-2544. https://doi.org/10.1097/j.pain.0000000000000326
47. Fukami Y, Terasaki M, Okamoto Y, Sakaguchi K, Murata T, Ohkubo M, et al. Efficacy of preoperative dexamethasone in patients with laparoscopic cholecystectomy: a prospective randomized double-blind study. J Hepatobiliary Pancreat Surg. 2009;16(3):367-371. https://doi.org/10.1007/s00534-009-0079-5
48. Datta M. Preoperative Single Dose Dexamethasone Effectively Diminishes Postoperative Pain after Laparoscopic Surgery. J Clin Diagn Res. 2020.
49. Küçüksaraç G, Arslan KR, Sahin AS, Arslan K. Effect of Dexamethasone on Postoperative Analgesia Following the Transversus Abdominis Plane Block in Gynecological Laparotomies. Cureus. 2024;16(11):e73356. https://doi.org/10.7759/cureus.73814
50. Parihar A, Shukla N, Saxena A, Nigam S. Comparison of Post Operative Analgesic Efficacy of Dexamethasone as an Adjuvant with Ropivacaine 0.25% and Plain Ropivacaine 0.25%, Using Ultrasound Guided Tap Block after Total Abdominal Hysterectomy: A Randomized Controlled Trial. Acta Med Int. 2024;11(1):27-31. https://doi.org/10.4103/amit.amit_85_23
51. Roy S, Datta S. Effect of intravenous dexamethasone on spinal anaesthesia with bupivacaine plus fentanyl in patients undergoing vaginal hysterectomy. Age (yr). 2017;46(4.1):45.6-3.8.
52. Jokela RM, Ahonen JV, Tallgren MK, Marjakangas PC, Korttila KT. The effective analgesic dose of dexamethasone after laparoscopic hysterectomy. Anesth Analg. 2009;109(2):607-615. https://doi.org/10.1213/ane.0b013e3181ac0f5c
53. Corcoran T, Kasza J, Short T, O’loughlin E, Chan M, Leslie K, et al. Intraoperative dexamethasone does not increase the risk of postoperative wound infection: a propensity score-matched post hoc analysis of the ENIGMA-II trial (EnDEX). Br J Anaesth. 2017;118(2):190-199. https://doi.org/10.1093/bja/aew446
54. Ismael H, Horst M, Farooq M, Jordon J, Patton JH, Rubinfeld IS. Adverse effects of preoperative steroid use on surgical outcomes. Am J Surg. 2011;201(3):305-309. https://doi.org/10.1016/j.amjsurg.2010.09.018
55. Samimi SS, Bastanhagh E, Mohammadi S, Shariat MR, Pourfakhr P, Smith J. Hyperglycemic Response of Non-diabetic Women Undergoing Abdominal Hysterectomy Who Have Received Prophylactic Dexamethasone to Alleviate Nausea and Vomiting. Anesth Pain Med. 2020;10(5):e107893.
56. Sekhavat L, Davar R, Behdad S. Efficacy of prophylactic dexamethasone in prevention of postoperative nausea and vomiting. J Epidemiol Glob Health. 2015;5(2):175-179. https://doi.org/10.1016/j.jegh.2014.07.004
57. Sharma AN, Shankaranarayana P. Postoperative nausea and vomiting: palonosetron with dexamethasone vs. ondansetron with dexamethasone in laparoscopic hysterectomies. Oman Med J. 2015;30(4):252-256. https://doi.org/10.5001/omj.2015.51
58. Fujii Y. Reduction of Postoperative Nausea and Vomiting and Analgesic Requirement with Dexamethasone in Women Undergoing General Anesthesia for Mastectomy. J Clin Anesth. 2007;13(7):564-568. https://doi.org/10.1111/j.1524-4741.2007.00497.x
59. Dick W, am Esch JS. Prophylaxe von postoperativer Übelkeit und postoperativem Erbrechen. Anasthesiol Intensivmed Notfallmed Schmerzther. 1997;32(10):616-621. https://doi.org/10.1055/s-2007-995117
60. Gan TJ, Coop A, Philip BK, Group KS. A randomized, double-blind study of granisetron plus dexamethasone versus ondansetron plus dexamethasone to prevent postoperative nausea and vomiting in patients undergoing abdominal hysterectomy. Anesth Analg. 2005;101(5):1323-1329. https://doi.org/10.1213/01.ANE.0000180366.65267.F6
61. Corcoran TB, Martin C, O’Loughlin E, Ho KM, Coutts P, Chan MT, et al. Dexamethasone and clinically significant postoperative nausea and vomiting: a prespecified substudy of the randomised perioperative administration of dexamethasone and infection (PADDI) trial. Br J Anaesth. 2022;129(3):327-335. https://doi.org/10.1016/j.bja.2022.05.018
62. Apfel CC, Korttila K, Abdalla M, Kerger H, Turan A, Vedder I, et al. A factorial trial of six interventions for the prevention of postoperative nausea and vomiting. N Engl J Med. 2004;350(24):2441-2451. https://doi.org/10.1056/NEJMoa032196
63. Li G, Lv Y, Gao S, Yao X, Ren S, Dong L, et al. Esketamine/dexmedetomidine-based opioid-free anesthesia and its association with postoperative bowel and cognitive dysfunction after total laparoscopic hysterectomy. BMC Anesthesiol. 2025;25(1):422. https://doi.org/10.1186/s12871-025-03301-w
64. Ramirez NL, Barba N, Flores E, Gracia-Filion P, Mahnert N. Opioid use and postoperative pain after hysterectomy. Am J Obstet Gynecol. 2024;230(4):S1271-S1273. https://doi.org/10.1016/j.ajog.2024.02.196
65. Bougie O, Blom J, Zhou G, Murji A, Thurston J. Use and misuse of opioid after gynecologic surgery. Best Pract Res Clin Obstet Gynaecol. 2022;85:23-34. https://doi.org/10.1016/j.bpobgyn.2022.07.005
66. Madsen AM, Martin JM, Linder BJ, Gebhart JB. Perioperative opioid management for minimally invasive hysterectomy. Best Pract Res Clin Obstet Gynaecol. 2022;85:68-80. https://doi.org/10.1016/j.bpobgyn.2022.05.006
67. Ready LB, Chadwick H, Ross B. Age predicts effective epidural morphine dose after abdominal hysterectomy. Anesth Analg. 1987;66(12):1215-1218. https://doi.org/10.1213/00000539-198712000-00002
68. Jno-Baptiste B, Scarlett MD, Harding HE. The effect of dexamethasone on postoperative opioid requirement in patients who underwent gynecology surgery at the university hospital in Jamaica. J Anesth Clin Res. 2014;5(470):2.
69. Lloret-Linares C, Lopes A, Declèves X, Serrie A, Mouly S, Bergmann JF, et al. Challenges in the optimisation of post-operative pain management with opioids in obese patients: a literature review. Obes Surg. 2013;23(9):1458-1475. https://doi.org/10.1007/s11695-013-0998-8
70. Laconi G, Coppens S, Roofthooft E, Van De Velde M. High dose glucocorticoids for treatment of postoperative pain: A systematic review of the literature and meta-analysis. J Clin Anesth. 2024;93:111352. https://doi.org/10.1016/j.jclinane.2023.111352
71. Yang C, Li Y, Hu J, Wu J, Huang S. The relationship between pre-operative glycosylated haemoglobin and opioid consumption after caesarean section in women with gestational diabetes mellitus. Front Endocrinol (Lausanne). 2022;13:910914. https://doi.org/10.3389/fendo.2022.910914
72. Setji TL, Gilmore L, Freeman S. Perioperative diabetes management. Diabetes Manag. 2018;8:67-73.
73. Andres S, Shu MK, Kent A, Greenberg D, Danakas G. Multimodal pain management after robotic-assisted total laparoscopic hysterectomy reduces postoperative opioid use and pain scores. Am J Obstet Gynecol. 2023;228(6):S1180. https://doi.org/10.1016/j.ygyno.2023.06.100
74. Corcoran TB, O’Loughlin E, Chan MT, Ho KM. Perioperative ADministration of Dexamethasone And blood Glucose concentrations in patients undergoing elective non-cardiac surgery-the randomised controlled PADDAG trial. Eur J Anaesthesiol. 2021;38(9):932-942. https://doi.org/10.1097/EJA.0000000000001294
75. Jones IA, LoBasso MA, Wier J, Gettleman BS, Richardson MK, Ratto CE, et al. Perioperative dexamethasone in diabetic patients: a systematic review and meta-analysis of randomized, placebo-controlled trials. Anesth Analg. 2024;139(3):479-489. https://doi.org/10.1213/ANE.0000000000007007
76. Qi M, Xiao W, Yang S, Wang S, Zhou L, Wan A, et al. Pre-Incisional preventive precise Multimodal analgesia may enhance the rehabilitation process of acute postoperative pain following total Laparoscopic hysterectomy: A randomized controlled trial. Pain Physician. 2023;26(3):E123-E133. https://doi.org/10.36076/ppj.2023.26.E123
77. Shanmugasundaram S, SK B, Kumar CA, Periaswamy P. Comparative Analysis of Epidural Dexamethasone and Epidural Morphine for Postoperative Pain Control After Total Abdominal Hysterectomy: A Randomized Clinical Trial. J Cell Mol Anesth. 2024;9(3):1-8. https://doi.org/10.5812/jcma-146995
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| Issue | Vol 9 No 1 (2026) | |
| Section | Original Article(s) | |
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| Hysterectomy Dexamethasone Postoperative Pain | ||
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How to Cite
1.
Shokri Emami F, Zamani Kiasari A, Sobhani S. The Effect of Preoperative Injectable Dexamethasone on Postoperative Pain Following Hysterectomy in Patients Hospitalized at Imam Hospital of Sari in 2024-2025. AJS. 2026;9(1):34-49.
