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Langenbeck's Archives of Surgery
Published in: Langenbeck's Archives of Surgery 8/2015

01-12-2015 | Systematic Review and Meta-analysis

Effect of perioperative dexamethasone on subjective voice quality after thyroidectomy: a meta-analysis and systematic review

Authors: Shih-Ping Cheng, Tsang-Pai Liu, Po-Sheng Yang, Kuo-Sheng Lee, Chien-Liang Liu

Published in: Langenbeck's Archives of Surgery | Issue 8/2015

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Abstract

Background

Prophylactic dexamethasone has been shown to reduce postoperative pain, nausea, and vomiting in patients undergoing thyroidectomy. However, its effects on postoperative voice outcomes remain uncertain.

Methods

A systematic review and meta-analysis of the literature was conducted. Cochrane database, MEDLINE, EMBASE, and CINAHL were thoroughly searched. Studies that compared intravenous dexamethasone administration with no dexamethasone in patients undergoing thyroidectomy were included. Main outcome measure was the difference in postoperative voice assessment between groups. Standardized mean difference (SMD) and 95 % confidence intervals (CIs) were estimated using fixed and random effects models.

Results

Four studies with a total of 313 patients met inclusion criteria. Significant heterogeneity of study results was noted. Using random effects models, pooled data showed no difference in subjective voice quality between groups preoperatively (SMD, 0.29; 95 % CI −0.37 to 0.96; P = 0.39), 24 h after thyroidectomy (SMD, −1.02; 95 % CI −2.36 to 0.31; P = 0.13), or at 48 h (SMD, −0.05; 95 % CI −0.30 to 0.21; P = 0.72). A sensitivity analysis excluding one observational study yielded similar results.

Conclusion

There are insufficient data for definite conclusions to be drawn regarding the effectiveness of a single perioperative administration of dexamethasone to reduce short-term voice disturbances after thyroidectomy. Further prospective trials using objective voice analysis are warranted to evaluate the efficacy of dexamethasone.
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Metadata
Title
Effect of perioperative dexamethasone on subjective voice quality after thyroidectomy: a meta-analysis and systematic review
Authors
Shih-Ping Cheng
Tsang-Pai Liu
Po-Sheng Yang
Kuo-Sheng Lee
Chien-Liang Liu
Publication date
01-12-2015
Publisher
Springer Berlin Heidelberg
Published in
Langenbeck's Archives of Surgery / Issue 8/2015
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-015-1354-3

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