The efficacy of single-dose postoperative intravenous dexamethasone for pain relief after endoscopic submucosal dissection for gastric neoplasm

Hye Won Lee, Hyuk Lee, Hyunsoo Chung, Jun Chul Park, Sung Kwan Shin, Sang Kil Lee, Young Chan Lee, Jung Hwa Hong, Dong Wook Kim

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Endoscopic submucosal dissection (ESD) is the gold standard technique for en bloc resection of large superficial tumors in the upper and lower gastrointestinal tract. Little is known about the management of epigastric pain after ESD of gastric neoplasms. This study investigated the utility and safety of single-dose, perioperative, intravenous dexamethasone for epigastric pain relief following ESD. Methods: The efficacy of intravenous dexamethasone 0.15 mg/kg (DEXA group) compared with saline-only placebo (placebo) for epigastric pain after ESD of early gastric neoplasms was assessed in a double-blinded, placebo-controlled trial. Patients completed a questionnaire about present pain intensity (PPI) and short-form McGill pain (SF-MP) categories for immediate and 6-, 12-, and 24-h postoperative periods. The primary outcome variable was PPI at 6 h following ESD. Secondary outcome variables included pain medication, SF-MP scores, complications, second-look endoscopic findings, and length of stay. Results: A total of 36 patients participated in the study. The mean 6-h PPI value was lower (p < 0.001) in the DEXA group (1.61 ± 0.21) than in the placebo group (2.66 ± 0.19). The total 6-h SF-MP score, especially the sensory domain, was higher (p = 0.054) in the placebo group (11.56 ± 0.75) than in the DEXA group (8.89 ± 0.75). Tramadol for epigastric pain relief was more frequent (p = 0.026) in the placebo group (44.4%) than in the DEXA group (11.1%). No differences were noted between groups in length of stay or complications, including acute or delayed bleeding. The distribution of artificial ulcer patterns at 48-h post-ESD as determined by second-look endoscopy was similar in both groups. Conclusion: Single-dose perioperative intravenous dexamethasone after ESD effectively relieved epigastric pain 6 h postoperatively.

Original languageEnglish
Pages (from-to)2334-2341
Number of pages8
JournalSurgical endoscopy
Volume28
Issue number8
DOIs
Publication statusPublished - 2014 Aug

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Dexamethasone
Stomach Neoplasms
Pain
Placebos
Length of Stay
Endoscopic Mucosal Resection
Lower Gastrointestinal Tract
Tramadol
Upper Gastrointestinal Tract
Pain Management
Postoperative Period
Endoscopy
Ulcer
Hemorrhage
Safety

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Lee, Hye Won ; Lee, Hyuk ; Chung, Hyunsoo ; Park, Jun Chul ; Shin, Sung Kwan ; Lee, Sang Kil ; Lee, Young Chan ; Hong, Jung Hwa ; Kim, Dong Wook. / The efficacy of single-dose postoperative intravenous dexamethasone for pain relief after endoscopic submucosal dissection for gastric neoplasm. In: Surgical endoscopy. 2014 ; Vol. 28, No. 8. pp. 2334-2341.
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title = "The efficacy of single-dose postoperative intravenous dexamethasone for pain relief after endoscopic submucosal dissection for gastric neoplasm",
abstract = "Background: Endoscopic submucosal dissection (ESD) is the gold standard technique for en bloc resection of large superficial tumors in the upper and lower gastrointestinal tract. Little is known about the management of epigastric pain after ESD of gastric neoplasms. This study investigated the utility and safety of single-dose, perioperative, intravenous dexamethasone for epigastric pain relief following ESD. Methods: The efficacy of intravenous dexamethasone 0.15 mg/kg (DEXA group) compared with saline-only placebo (placebo) for epigastric pain after ESD of early gastric neoplasms was assessed in a double-blinded, placebo-controlled trial. Patients completed a questionnaire about present pain intensity (PPI) and short-form McGill pain (SF-MP) categories for immediate and 6-, 12-, and 24-h postoperative periods. The primary outcome variable was PPI at 6 h following ESD. Secondary outcome variables included pain medication, SF-MP scores, complications, second-look endoscopic findings, and length of stay. Results: A total of 36 patients participated in the study. The mean 6-h PPI value was lower (p < 0.001) in the DEXA group (1.61 ± 0.21) than in the placebo group (2.66 ± 0.19). The total 6-h SF-MP score, especially the sensory domain, was higher (p = 0.054) in the placebo group (11.56 ± 0.75) than in the DEXA group (8.89 ± 0.75). Tramadol for epigastric pain relief was more frequent (p = 0.026) in the placebo group (44.4{\%}) than in the DEXA group (11.1{\%}). No differences were noted between groups in length of stay or complications, including acute or delayed bleeding. The distribution of artificial ulcer patterns at 48-h post-ESD as determined by second-look endoscopy was similar in both groups. Conclusion: Single-dose perioperative intravenous dexamethasone after ESD effectively relieved epigastric pain 6 h postoperatively.",
author = "Lee, {Hye Won} and Hyuk Lee and Hyunsoo Chung and Park, {Jun Chul} and Shin, {Sung Kwan} and Lee, {Sang Kil} and Lee, {Young Chan} and Hong, {Jung Hwa} and Kim, {Dong Wook}",
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The efficacy of single-dose postoperative intravenous dexamethasone for pain relief after endoscopic submucosal dissection for gastric neoplasm. / Lee, Hye Won; Lee, Hyuk; Chung, Hyunsoo; Park, Jun Chul; Shin, Sung Kwan; Lee, Sang Kil; Lee, Young Chan; Hong, Jung Hwa; Kim, Dong Wook.

In: Surgical endoscopy, Vol. 28, No. 8, 08.2014, p. 2334-2341.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The efficacy of single-dose postoperative intravenous dexamethasone for pain relief after endoscopic submucosal dissection for gastric neoplasm

AU - Lee, Hye Won

AU - Lee, Hyuk

AU - Chung, Hyunsoo

AU - Park, Jun Chul

AU - Shin, Sung Kwan

AU - Lee, Sang Kil

AU - Lee, Young Chan

AU - Hong, Jung Hwa

AU - Kim, Dong Wook

PY - 2014/8

Y1 - 2014/8

N2 - Background: Endoscopic submucosal dissection (ESD) is the gold standard technique for en bloc resection of large superficial tumors in the upper and lower gastrointestinal tract. Little is known about the management of epigastric pain after ESD of gastric neoplasms. This study investigated the utility and safety of single-dose, perioperative, intravenous dexamethasone for epigastric pain relief following ESD. Methods: The efficacy of intravenous dexamethasone 0.15 mg/kg (DEXA group) compared with saline-only placebo (placebo) for epigastric pain after ESD of early gastric neoplasms was assessed in a double-blinded, placebo-controlled trial. Patients completed a questionnaire about present pain intensity (PPI) and short-form McGill pain (SF-MP) categories for immediate and 6-, 12-, and 24-h postoperative periods. The primary outcome variable was PPI at 6 h following ESD. Secondary outcome variables included pain medication, SF-MP scores, complications, second-look endoscopic findings, and length of stay. Results: A total of 36 patients participated in the study. The mean 6-h PPI value was lower (p < 0.001) in the DEXA group (1.61 ± 0.21) than in the placebo group (2.66 ± 0.19). The total 6-h SF-MP score, especially the sensory domain, was higher (p = 0.054) in the placebo group (11.56 ± 0.75) than in the DEXA group (8.89 ± 0.75). Tramadol for epigastric pain relief was more frequent (p = 0.026) in the placebo group (44.4%) than in the DEXA group (11.1%). No differences were noted between groups in length of stay or complications, including acute or delayed bleeding. The distribution of artificial ulcer patterns at 48-h post-ESD as determined by second-look endoscopy was similar in both groups. Conclusion: Single-dose perioperative intravenous dexamethasone after ESD effectively relieved epigastric pain 6 h postoperatively.

AB - Background: Endoscopic submucosal dissection (ESD) is the gold standard technique for en bloc resection of large superficial tumors in the upper and lower gastrointestinal tract. Little is known about the management of epigastric pain after ESD of gastric neoplasms. This study investigated the utility and safety of single-dose, perioperative, intravenous dexamethasone for epigastric pain relief following ESD. Methods: The efficacy of intravenous dexamethasone 0.15 mg/kg (DEXA group) compared with saline-only placebo (placebo) for epigastric pain after ESD of early gastric neoplasms was assessed in a double-blinded, placebo-controlled trial. Patients completed a questionnaire about present pain intensity (PPI) and short-form McGill pain (SF-MP) categories for immediate and 6-, 12-, and 24-h postoperative periods. The primary outcome variable was PPI at 6 h following ESD. Secondary outcome variables included pain medication, SF-MP scores, complications, second-look endoscopic findings, and length of stay. Results: A total of 36 patients participated in the study. The mean 6-h PPI value was lower (p < 0.001) in the DEXA group (1.61 ± 0.21) than in the placebo group (2.66 ± 0.19). The total 6-h SF-MP score, especially the sensory domain, was higher (p = 0.054) in the placebo group (11.56 ± 0.75) than in the DEXA group (8.89 ± 0.75). Tramadol for epigastric pain relief was more frequent (p = 0.026) in the placebo group (44.4%) than in the DEXA group (11.1%). No differences were noted between groups in length of stay or complications, including acute or delayed bleeding. The distribution of artificial ulcer patterns at 48-h post-ESD as determined by second-look endoscopy was similar in both groups. Conclusion: Single-dose perioperative intravenous dexamethasone after ESD effectively relieved epigastric pain 6 h postoperatively.

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