Impact of preoperative dexamethasone versus placebo on quality of recovery in patients undergoing surgery for gastrointestinal and hepato-pancreato-biliary malignancy- Randomized controlled trial

Postoperative systemic inflammatory-immune dysregulation is a key component of the body’s response to surgical injury, increasing the risk of complications and leading to extended hospital stays. Perioperative glucocorticoid can suppress this response, thereby reducing complication and enhancing post-operative recovery

One of the primary mechanisms of glucocorticoids is their ability to suppress inflammation. They inhibit the transcription of key pro-inflammatory transcription factors such as AP-1, NF-kB, and STAT3, which leads to a reduction in the production of pro-inflammatory cytokines.However, the use of glucocorticoid in improving the post operative quality of recovery among patients of gastrointestinal malignancy (GI) and hepato pancreto-biliary(HPB) malignancy is limited.

Numerous article report safety of glucocorticoids and their use for postoperative nausea, vomiting and pain. Most studies report that their use reduces the post operative complication without increasing blood sugar level and risk of surgical site infection. However no study directly examine the effect of preoperative dexamethasone on improving quality of recovery in patient of GI and HPB malignancy after curative surgery.

Therefore, aim of the study is to assess the impact of preoperative dexamethasone versus placebo on quality of recovery in patients undergoing surgery for gastrointestinal(GI) and hepato-pancreato-biliary (HPB) malignancy