The effect of intraoperative administration of dexamethasone for PONV prophylaxis on perioperative blood glucose level in obese and normal weight children

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. Patients and methods: This prospective observational study included 62 children. All patients received total intravenous anesthesia and a single dose of dexamethasone (0.15 mg/kg, maximum 8 mg). Blood glucose levels were measured up to 6 h. Standard deviation scores (SDS) were calculated using age-and gender-specific body mass index (BMI) percentiles, p < 0.05. Results: A total of 62 children (11.5 +/- 2.9 years, median SDS 0.43, 29% overweight/obese) were included. Blood glucose levels increased from 5.52 +/- 0.52 to 6.74 +/- 0.84 mmol/L 6 h after dexamethasone without correlation to the BMI-SDS. Conclusions: This study showed an increase of perioperative blood glucose (normoglycemic ranges) after single dose of dexamethasone, but no BMI-dependent effect was observed in children. Therefore, low-dose dexamethasone may be used in obese children for PONV prophylaxis.