Assessing the prevalence of dexamethasone use in patients undergoing surgery, and subsequent glucose measurements: a retrospective cohort study

A single dose of glucocorticoid can cause hyperglycaemia. Hyperglycaemia is associated with poor outcomes in all surgical specialties. Dexamethasone is widely used to prevent postoperative nausea and vomiting. We aimed to assess how many individuals were given dexamethasone as part of their general anaesthetic regimen, and how many had a subsequent capillary blood glucose concentration measured during the next 24 hours. We undertook a retrospective case‐note analysis, set in a single centre teaching hospital, of all patients undergoing surgery during one week in August 2013. In terms of interventions and measurements, we assessed how many patients were given dexamethasone perioperatively and the number of patients who had a capillary blood glucose concentration measured during the subsequent 24 hours. It was found that 373 patients had had a general anaesthetic; 18 sets of case notes were unavailable. A total of 234 patients (66%) had dexamethasone. Twenty of the 355 (5.7%) had a blood glucose measured prior to surgery, 14 of whom had diabetes. Only 16/355 (4.5%) people had a blood glucose level measured during the first 24 hours after surgery. All of these had diabetes. Despite evidence that postoperative hyperglycaemia is associated with harm, and that glucocorticoids are associated with hyperglycaemia, glucose levels are not commonly measured after dexamethasone administration. Copyright © 2017 John Wiley & Sons.