Perioperative medicine & outcomes
Impact of Intraoperative Dexamethasone on Perioperative Blood Glucose Levels: Systematic Review and Meta-Analysis of Randomized Trials
Authors' conclusion
Mean blood glucose levels rise between 0.37 and 1.63 mmol L-1 (6.7 and 29.4 mg dL-1) within 24 hours after a single dose of dexamethasone administered at induction of anesthesia compared to control, but in most patients this difference will not be clinically relevant.
Study context
- Population
- Adults undergoing noncardiac surgery
- Participants
- 11,154 adults · 23 randomized controlled trials (RCTs)
- Comparison
- Single intraoperative dose of dexamethasone vs control
- Outcome
- Maximum blood glucose and variation from baseline within 24 h of surgery; blood glucose and variation from baseline at 2, 4, 8, 12 and 24 h after dexamethasone
- Follow-up
- Within 24 hours
Methodological detailsrandom-effects model, Grading of Recommendations, Assessment, Development, and Evaluations (GRADE)
- Random-effects model
- GRADE
Pooled result
As reported in the abstract
Blood glucose increase vs control
Dexamethasone vs ControlIncrease, mmol L-1 (95% CI)
At 2 hours; 6.7 mg dL-1 (2.9-10.5)
0.37(0.16–0.58)
At 4 hours; 17.5 mg dL-1 (12.1-22.5)
0.97(0.67–1.25)
At 8 hours; 17.3 mg dL-1 (9.9-24.5)
0.96(0.55–1.36)
At 12 hours; 16.2 mg dL-1 (11.2-21.4)
0.90(0.62–1.19)
At 24 hours; 10.6 mg dL-1 (4.0-17.3)
0.59(0.22–0.96)
Further pooled results
Subgroups: diabetic status (diabetes vs no diabetes) (subgroup)
- No subgroup difference in all outcomes except maximum blood glucose variation within 24 h and variation at 4 h
Subgroups: dexamethasone dose (4-5 mg vs 8-10 mg) (subgroup)
- No subgroup difference in all outcomes except blood glucose at 24 h and hyperglycemic events
Original publication
Impact of Intraoperative Dexamethasone on Perioperative Blood Glucose Levels: Systematic Review and Meta-Analysis of Randomized Trials. Anesth Analg. Published 16 August 2024. doi:10.
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