TY - JOUR
T1 - The effect of dexamethasone on inflammatory markers of surgical stress
T2 - a randomized trial in robotic hysterectomy
AU - Kaiser, Karsten
AU - Karstensen, Sven Hoedt
AU - Petersen, Sofie Ronja
AU - Nielsen, Kristian Als
AU - Valorenzos, Alexandros Valsamidis
AU - Strøm, Thomas
AU - Gögenur, Ismail
AU - Balsevicius, Lukas
AU - Lauszus, Finn Friis
N1 - © 2026. The Author(s).
PY - 2026/6/3
Y1 - 2026/6/3
N2 - BACKGROUND AND AIM: The immunosuppressive action of dexamethasone may help reduce the risk of postoperative complications such as infection, adhesion formation, and delayed wound healing. Dexamethasone may mitigate tissue damage and hasten recovery by attenuating the inflammatory response, modulating immune cell activity, and reducing the release of pro-inflammatory cytokines. In this first randomized trial of dexamethasone in robotic hysterectomy, we aimed to evaluate its effect on reducing C-reactive protein (CRP) as a proxy marker of surgical stress.METHODS: Women scheduled for robotic-assisted hysterectomy were recruited into a randomized trial comparing a preoperative dose of 24 mg dexamethasone with placebo. Blood tests were obtained, and visual analogue scale scores for pain, postoperative nausea and vomiting, and medication use during admission were recorded at 0, 4, 8, 12, and 24 h postoperatively.RESULTS: Among the 112 included women, postoperative CRP levels were lower in the dexamethasone group at 12 and 24 h. Postoperative nausea and vomiting over time were also reduced in the dexamethasone group (p = 0.039 without adjustment; p = 0.02 with adjustment). Changes in CRP were analyzed using repeated-measures analysis, showing highly significant differences both without and with adjustment for BMI, age, and baseline CRP (both p < 0.001). Overall, the dexamethasone group demonstrated substantially lower CRP levels during the postoperative period.CONCLUSION: Dexamethasone significantly reduced postoperative CRP levels, suggesting a potential role in further reducing surgical stress in robotic-assisted hysterectomy.TRIAL REGISTRATION: European medical agency (EUDRACT no.2021-000874-28). 02.06.2021. CTIS Public Portal (European Medicines Agency) Registry of randomized clinical trials: NCT04762381, "Effect of 24mg Dexamethasone Preoperatively on Surgical Stress, Pain and Recovery in Robotic-assisted Laparoscopic Hysterectomy", 11th March 2022.CLINICALTRIALS: gov.
AB - BACKGROUND AND AIM: The immunosuppressive action of dexamethasone may help reduce the risk of postoperative complications such as infection, adhesion formation, and delayed wound healing. Dexamethasone may mitigate tissue damage and hasten recovery by attenuating the inflammatory response, modulating immune cell activity, and reducing the release of pro-inflammatory cytokines. In this first randomized trial of dexamethasone in robotic hysterectomy, we aimed to evaluate its effect on reducing C-reactive protein (CRP) as a proxy marker of surgical stress.METHODS: Women scheduled for robotic-assisted hysterectomy were recruited into a randomized trial comparing a preoperative dose of 24 mg dexamethasone with placebo. Blood tests were obtained, and visual analogue scale scores for pain, postoperative nausea and vomiting, and medication use during admission were recorded at 0, 4, 8, 12, and 24 h postoperatively.RESULTS: Among the 112 included women, postoperative CRP levels were lower in the dexamethasone group at 12 and 24 h. Postoperative nausea and vomiting over time were also reduced in the dexamethasone group (p = 0.039 without adjustment; p = 0.02 with adjustment). Changes in CRP were analyzed using repeated-measures analysis, showing highly significant differences both without and with adjustment for BMI, age, and baseline CRP (both p < 0.001). Overall, the dexamethasone group demonstrated substantially lower CRP levels during the postoperative period.CONCLUSION: Dexamethasone significantly reduced postoperative CRP levels, suggesting a potential role in further reducing surgical stress in robotic-assisted hysterectomy.TRIAL REGISTRATION: European medical agency (EUDRACT no.2021-000874-28). 02.06.2021. CTIS Public Portal (European Medicines Agency) Registry of randomized clinical trials: NCT04762381, "Effect of 24mg Dexamethasone Preoperatively on Surgical Stress, Pain and Recovery in Robotic-assisted Laparoscopic Hysterectomy", 11th March 2022.CLINICALTRIALS: gov.
KW - Adult
KW - Anti-Inflammatory Agents/therapeutic use
KW - Biomarkers/blood
KW - C-Reactive Protein/metabolism
KW - Dexamethasone/therapeutic use
KW - Double-Blind Method
KW - Female
KW - Glucocorticoids/therapeutic use
KW - Humans
KW - Hysterectomy/methods
KW - Middle Aged
KW - Postoperative Nausea and Vomiting/prevention & control
KW - Postoperative Pain/prevention & control
KW - Robotic Surgical Procedures/adverse effects
U2 - 10.1186/s12893-026-03664-y
DO - 10.1186/s12893-026-03664-y
M3 - Article
C2 - 42237296
SN - 1471-2482
VL - 26
JO - BMC Surgery
JF - BMC Surgery
IS - 1
ER -