The effect of dexamethasone on pain control after thyroid surgery: a meta-analysis of randomized controlled trials

Introduction The effect of dexamethasone on postoperative pain after thyroid surgery remains controversial. We conduct a systematic review and meta-analysis to explore the influence of dexamethasone versus placebo on postoperative pain after thyroid surgery. Methods We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through May 2020 for randomized controlled trials (RCTs) assessing the effect of dexamethasone versus placebo on postoperative pain after thyroid surgery. This meta-analysis is performed using the random-effect model. Results Eight RCTs involving 734 patients are included in the meta-analysis. Overall, compared with control group for thyroid surgery, dexamethasone shows significantly reduced pain scores (SMD = - 0.82; 95% CI - 1.08 to - 0.56;P < 0.00001), number of required analgesics (OR = 0.18; 95% CI 0.11-0.31;P < 0.00001), analgesic consumption (SMD = - 0.38; 95% CI - 0.63 to - 0.13;P = 0.003), nausea and vomiting (OR = 0.38; 95% CI 0.17-0.86;P = 0.02), as well as rescue antiemetics (OR = 0.40; 95% CI 0.20-0.79;P = 0.008). Conclusions Perioperative dexamethasone is effective to reduce the pain, nausea and vomiting after thyroid surgery.