Title of Article: Efficacy of Perioperative Intravenous Dexamethasone on Postoperative Analgesia in Scleral Buckle Surgery: A Randomized Clinical Trial
What are the key takeaways from the article:
As a method to reconnect a retina that has separated from the remainder of the eye, scleral buckling is a surgical procedure aimed at restoring normal vision. Oftentimes, patients of such interventions note the onset of pain, however, standardized use and enhancement of analgesia has not been implemented in widespread practice. Potential candidates to use for postoperative analgesia includes ketorolac (a non-steroidal anti-inflammatory) and dexamethasone (a corticosteroid) - the utility of the latter was investigated.
Henderson et al. (2023) recruited adult patients undergoing rhegmatogenous retinal detachment (RRD) surgery and 45 were randomized into the control group (offered the standard of care) or the intervention group (offered the standard of care + 8mg IV dexamethasone). Supportive ASA or acetaminophen/oxycodone was taken after surgery depending on the severity of pain experienced. Surveys were completed on the night of the procedure, the first day after surgery and one week after surgery to elucidate patients’ pain and number of tablets used.
Those in the intervention arm experienced significantly less pain (p =0.002) and opioid consumption (p=0.016) compared to the control group on the night following the procedure. Over the course of the postoperative week, absolute opioid consumption was also lower in the intervention group (p=0.047), however, the difference in pain was no longer present (p=0.311).
Thus, this study supports the current literature indicating that single portion dexamethasone can aid in decreasing post surgical pain and opioid use immediately post procedure.
Publication Date: March 8, 2023
Henderson, M. N., Mantopoulos, D., Wheatley, E. I., Hassan, O. T., Prenner, J. L., & Fine, H. F. (2023). Efficacy of Perioperative Intravenous Dexamethasone on Postoperative Analgesia in Scleral Buckle Surgery: A Randomized Clinical Trial. Ophthalmic surgery, lasers & imaging retina, 54(4), 238–242. https://doi.org/10.3928/23258160-20230222-01
Summary by: Partha Patel