Auswirkungen der intraoperativen Gabe von Dexamethason zur PONV-Prophylaxe auf den Blutzucker- und Cortisolspiegel bei normalgewichtigen und adipösen Kindern

• Main Author: Gnatzy, Richard
• Other Authors: Klinik und Poliklinik für Anästhesiologie und Intensivtherapie der Universität Leipzig, Medizinische Fakultät
• Format: Doctoral Thesis
• Language: deu
• Published: Universitätsbibliothek Leipzig 2015
• Subjects: PONV; Blutzucker; Antiemetika; Dexamethason; postoperative nausea; vomiting; blood glucose; antiemetics; dexamethasone; ddc:610
• Online Access: http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-172595; http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-172595; http://www.qucosa.de/fileadmin/data/qucosa/documents/17259/Dissertation_Gnatzy_02072015_FERTIG_farbig_Publikationsserver.pdf

Background: The incidence of postoperative nausea and vomiting (PONV) can be reduced by dexamethasone. Single dose administration may cause elevated blood glucose levels in obese adults. No data are available for children. Objective: The aim was to evaluate perioperative blood glucose changes related to body weight in children who received dexamethasone. Methods: This prospective observational study included 62 children. All patients received total intravenous anesthesia and a single dose of dexamethasone (0.15mg/kg, maximum 8mg). Blood glucose levels were measured up to 6 hours. Standard deviation scores (SDS) were calculated using age- and gender-specific BMI percentiles, p<0.05. Results: 62 children (11.5±2.9years, median SDS 0.43, 29% overweight/obese) were included. Blood glucose level increased from 5.52±0.52 to 6.74±0.84mmol/l 6h after dexamethasone without correlation to the BMI-SDS. Conclusions: This study shows an increase of perioperative blood glucose (normoglycemic ranges) after single dose of dexamethasone but no BMI-dependent effect in children. Therefore, low-dose dexamethasone may be used in obese children for PONV prophylaxis.