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Glucocorticoids may control inflammation by inhibiting many aspects of the inflammatoryprocess through increasing the transcription of anti-inflammatory genes and decreasing thetranscription of inflammatory genes.Glucocorticoids inhibit the transcription of several cytokines that are relevant ininflammatory diseases, including IL-1b, IL-2, IL-3, IL-6, IL-11, TNF-a, GM-CSF andchemokines that attract inflammatory cells to the site of inflammation, including IL8,RANTES, MCP-1, MCP-3, MCP-4, MIP-1a and eotaxin.The analgesic effect of glucocorticoids was first shown with betamethasone in patientsundergoing third molar extraction36. A group of doctors from the Helsinki UniversityHospital chose to investigate the analgesic potency of different doses of dexamethasone forpostoperative pain management of patients who underwent laparoscopic hysterectomy37. IVdexamethasone 15 mg before induction of anesthesia decreases the oxycodone consumptionduring the first 24 h after laparoscopic hysterectomy. During first 2 h after surgery,dexamethasone 10 mg reduces the oxycodone consumption as effectively as the 15 mg dose.The opioid-sparing potency of dexamethasone is dose dependent. The effect of the 5 mgdose on postoperative oxycodone consumption was negligible, whereas the 10 and 15 mgdoses reduced oxycodone consumption during the first 2 h after surgery.There is also some studies that presumed the prolonged analgesic effect of non steroidalanti-inflammatory drugs with dexamethasone; a group of experts from Scandinavia, havedemonstrated that the association of 16 mg of dexamethasone with rofecoxib has prolongedits analgesic effect38. It is also worth mentioning a cost related benefit of the use ofdexamethasone. Compared to costs of multiple doses of non-steroidal antiinflammatorydrugs used during and after this procedure sounds reasonable to use a single dose ofdexamethasone in order to reduce consumption of analgesics.
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