Effekte von perioperativ appliziertem Dexamethason auf die postoperative Stimmungslage.

Binder, Laura

Thesis

Open Access

Effekte von perioperativ appliziertem Dexamethason auf die postoperative Stimmungslage.

Files

dlb.pdf (5.06 MB)

Date

2026-01-13

Authors

Binder, Laura

Supervisors

Person

Falkenberg, Irina

Abstract

Postoperative nausea and vomiting (PONV) are common and distressing complications following surgical procedures. In addition to significantly impairing patient comfort, PONV can also lead to increased healthcare costs. Effective prevention and management are therefore essential components of high-quality perioperative care. A differentiated approach that includes the identification of individual risk factors and the evidence-based use of antiemetic agents is required. The therapeutic benefits and potential side effects must be carefully balanced, necessitating further research on available pharmacological options. Corticosteroids, particularly dexamethasone, are well-established agents in perioperative PONV prophylaxis and are considered effective, safe, and cost-efficient. While the antiemetic efficacy of dexamethasone is well-documented, potential adverse effects, especially on postoperative mood, remain insufficiently studied. Although long-term corticosteroid therapy can induce psychiatric side effects, the impact of a single perioperative dose of dexamethasone is largely unknown. This study analyzes data from 3,061 patients to assess whether dexamethasone, when administered in the recommended dosage for PONV prophylaxis, may cause relevant psychological side effects. The underlying patient data originate from the P6NV study, a randomized, prospective, interventional multicenter study analyzing the incidence of postoperative nausea and vomiting (PONV) in patients receiving routine pharmacological prophylaxis. Over a 24-hour observation period, questionnaires were used to assess PONV intensity (PIS), patient satisfaction (PPP33 questionnaire), and the incidence of side effects from administered antiemetics (PON-F). To investigate the impact of dexamethasone on postoperative mood, patients were divided into two groups: one receiving dexamethasone and one without dexamethasone administration. The results of these group comparisons aimed to identify potential psychological side effects of PONV prophylaxis with dexamethasone. Within the study, 2630 patients received dexamethasone for PONV prophylaxis, while 431 did not. The analysis suggests that the influence of dexamethasone on postoperative mood is minimal or negligible. Although significantly higher scores for positive emotions such as optimism and increased drive were observed in the dexamethasone group, these effects were not clinically relevant. Severe psychiatric side effects were not detected during the observation period. Instead, PONV incidence had the most significant negative impact on postoperative psychological well-being. No significant differences between the groups were found in the PPP33 questionnaire. Patients who received dexamethasone rated their mental and physical condition slightly more positively, particularly regarding orientation and body control, which could potentially enhance mobilization and recovery. In conclusion, the findings of this study indicate that dexamethasone does not have a clinically relevant effect on postoperative mood. The observed differences may be attributed to a mild fortifying effect of dexamethasone on emotional and cognitive well-being. Thus, dexamethasone remains a safe medication for the prophylaxis of perioperative nausea and vomiting, even concerning psychiatric side effects.