Effect of a single intraoperative dose of dexamethasone on glycemic profile in postoperative patients – an observational study
Abstract
Background & objective: Dexamethasone is a long-acting corticosteroid with minimal mineralocorticoid activity and is widely used in the perioperative setting owing to its immunomodulatory, anti-inflammatory, and antiemetic effects. However, concern persists regarding its potential to induce postoperative hyperglycemia in non-diabetic patients due to its gluconeogenic properties. We evaluated the alterations in blood glucose levels after a single intraoperative dose of dexamethasone and to determine its impact on the severity and incidence of PONV during the early postoperative period.
Materials and Methods: A prospective observational study was carried out on 100 non-diabetic adult patients (ASA I and II) undergoing elective surgery under general anesthesia (GA) at Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune. All of the patients were given a single intravenous dose of dexamethasone 8 mg following induction of GA. Fasting blood glucose was measured preoperatively, intraoperatively two hours after administration of dexamethasone, and Fasting Blood Glucose and Post Prandial Blood Glucose on postoperative days (POD) 1, 2, and 3. PONV was evaluated and was graded as none, mild, moderate, or severe. Chi-square tests and paired t-tests were used for the data analysis, with P < 0.05 being statistically significant.
Results: There was a statistically significant rise in blood glucose levels two hours after administration of
dexamethasone in comparison to preoperative fasting values (P < 0.05). Glucose levels returned to baseline over
POD 1–3 in a gradual manner without any clinical complications. Dexamethasone was effective in reducing the
incidence and severity of PONV, with most patients having no or only mild symptoms.
Conclusion: A single intraoperative dose of dexamethasone is associated with a transient but clinically tolerable rise in blood glucose in non-diabetic patients and is effective in reducing PONV. The benefits of its antiemetic action outweigh its short-term glycemic effects, and with appropriate perioperative monitoring, dexamethasone can be safely used in this patient population.
Keywords: Blood Glucose, Dexamethasone, General Anaesthesia, Non-Diabetic Patients, Postoperative
Hyperglycemia.
Citation: Shah B, Mainaparambil IS, Srinivasan NK. Effect of a single intraoperative dose of dexamethasone on
glycemic profile in postoperative patients – an observational study. Anaesth. pain intensive care 2025;29(9):1284
89. DOI: 10.35975/apic.v29i9.3066
Received: November 06, 2025; Revised: November 09, 2025; Accepted: November 14, 2025
