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Titolo:
Preoperative high dose methylprednisolone improves patients outcome after abdominal surgery
Autore:
Nagelschmidt, M; Fu, ZX; Saad, S; Dimmeler, S; Neugebauer, E;
Indirizzi:
Univ Cologne, Biochem & Expt Div, Dept Surg 2, DE-51109 Cologne, Germany Univ Cologne Cologne Germany DE-51109 Surg 2, DE-51109 Cologne, Germany Univ Cologne, Surg Clin, Dept Surg 2, D-5000 Cologne 41, Germany Univ Cologne Cologne Germany 41 Dept Surg 2, D-5000 Cologne 41, Germany Chongqing Med Univ, First Hosp, Dept Surg, Chongqing, Peoples R China Chongqing Med Univ Chongqing Peoples R China Chongqing, Peoples R China Univ Frankfurt, Med Clin 4, D-6000 Frankfurt, Germany Univ Frankfurt Frankfurt Germany D-6000 lin 4, D-6000 Frankfurt, Germany
Titolo Testata:
EUROPEAN JOURNAL OF SURGERY
fascicolo: 10, volume: 165, anno: 1999,
pagine: 971 - 978
SICI:
1102-4151(199910)165:10<971:PHDMIP>2.0.ZU;2-N
Fonte:
ISI
Lingua:
ENG
Soggetto:
LAPAROSCOPIC CHOLECYSTECTOMY; SYSTEMIC RESPONSE; COMBINED PREDNISOLONE; EPIDURAL ANALGESIA; METABOLIC RESPONSE; SURGICAL STRESS; COLONIC SURGERY; PAIN; CORTICOSTEROIDS; INDOMETHACIN;
Keywords:
intra-abdominal surgery; incisional hernia; glucocorticoid; fatigue; convalescence; breathing capacity; pain; stress response; hospital stay;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Neugebauer, E Univ Cologne, Biochem & Expt Div, Dept Surg 2, Ostmerheimer Str 200, DE-51109 Cologne, Germany Univ Cologne Ostmerheimer Str 200 Cologne Germany DE-51109
Citazione:
M. Nagelschmidt et al., "Preoperative high dose methylprednisolone improves patients outcome after abdominal surgery", EURO J SURG, 165(10), 1999, pp. 971-978

Abstract

Objective: To assess the effect of preoperative high dose methylprednisolone on stress response and outcome. Design: Randomised, placebo-controlled, double-blind study. Setting: University hospital, Germany. Subjects: 20 patients listed for abdominal surgery of whom 10 had major intra-abdominal interventions and 10 had incisional hernias repaired. Interventions: Methylprednisolone 30 mg/kg (100 mi) was given by slow intravenous infusion 90-60 minutes before operation. The control group receivedthe same volume of sodium chloride. Main outcome measures: Speed of convalescence, degree of fatigue, amount of pain, consumption of analgesics, breathing capacity, and hospital stay, as well as humoral and cellular mediators of the stress response. Results: Methylprednisolone significantly improved criteria of postoperative recovery, fatigue by 47%, (day 1), convalescence by about 45% (days 1-3), and breathing capacity (FEV1) between 47% and 29% (days 5, 7) (p < 0.05, ANOVA), and led to a significant reduction of median hospital stay of 4.5 days. C-reactive protein concentration was significantly decreased (by 46% on day 3) and T-cell activation was suppressed (day 1). Conclusion: Outcome of the patients after conventional abdominal surgery is substantially improved by preoperative high dose methylprednisolone. Thiseffect is more pronounced in patients having major operations.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/03/20 alle ore 13:48:29