N Engl J Med 2021 05;384(18):1731-1741
From Royal Perth Hospital (T.B.C., P.C., K.M.H.), the University of Western Australia (T.B.C., E.O., K.M.H.), Murdoch University (K.M.H.), and Fiona Stanley Hospital (E.O.), Perth, and the Alfred Hospital (P.S.M., A.C.C., L.A.B.), Monash University (T.B.C., P.S.M., A.B.F., A.C.C., L.A.B., K.L., C.M.), the University of Melbourne (K.L., D.S.), and Royal Melbourne Hospital (K.L.), Melbourne, VIC - all in Australia; the Chinese University of Hong Kong, Hong Kong (M.T.V.C.); and Auckland City Hospital and the University of Auckland - both in Auckland, New Zealand (T.G.S.).
Background: The glucocorticoid dexamethasone prevents nausea and vomiting after surgery, but there is concern that it may increase the risk of surgical-site infection.
Methods: In this pragmatic, international, noninferiority trial, we randomly assigned 8880 adult patients who were undergoing nonurgent, noncardiac surgery of at least 2 hours' duration, with a skin incision length longer than 5 cm and a postoperative overnight hospital stay, to receive 8 mg of intravenous dexamethasone or matching placebo while under anesthesia. Randomization was stratified according to diabetes status and trial center. Read More