{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T22:49:03Z","timestamp":1782514143645,"version":"3.54.5"},"reference-count":72,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["An\u00e4sthesiol Intensivmed Notfallmed Schmerzther"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Dexamethason ist ein hochpotentes, langwirksames synthetisches Glukokortikoid ohne mineralokortikoide Aktivit\u00e4t. Perioperativ wird es routinem\u00e4\u00dfig zur PONV-Prophylaxe eingesetzt, vielfach aber auch wegen einer vermeintlich relevanten Reduktion von postoperativen Schmerzen und einer damit einhergehenden Reduktion des Opioidbedarfs.<\/jats:p>\n                  <jats:p>Zusammenf\u00fchrung substanzbezogener Grundlagen, klinisch relevanter Applikationsformen, gebr\u00e4uchlicher Dosierungen, Kontraindikationen, unerw\u00fcnschter Wirkungen und Leitlinienempfehlungen.<\/jats:p>\n                  <jats:p>Parenterale Pr\u00e4parate enthalten typischerweise Dexamethason-21-dihydrogenphosphat, die relative antiinflammatorische Potenz liegt etwa 30-fach \u00fcber der von Cortisol. W\u00e4hrend h\u00f6here Dosierungen keinen proportionalen Zusatznutzen zu zeigen scheinen, dominieren in der Literatur intraven\u00f6se Einzeldosen von 4\u20138\u00a0mg. In diesen Dosierungen gilt Dexamethason als sicher. Insbesondere finden sich keine erh\u00f6hten Raten an postoperativen Wundinfektionen oder verz\u00f6gerter Wundheilung, jedoch ein leichter transitorischer Anstieg des Blutzuckerspiegels. Spezielle Risiken bestehen insbesondere bei h\u00e4matologischen Neoplasien durch das Tumorlysesyndrom sowie in der endokrinologischen Diagnostik infolge einer Suppression der Hypothalamus-Hypophysen-Nebennierenrinden-Achse. Aktuelle Leitlinien verorten Dexamethason zunehmend als Bestandteil balancierter Analgesiekonzepte, teils mit Wiederholungsdosen im Rahmen von ERAS-Protokollen.<\/jats:p>\n                  <jats:p>Bei sorgf\u00e4ltiger Nutzen-Risiko-Abw\u00e4gung kann Dexamethason einen kleinen, aber konsistenten Beitrag zur postoperativen Analgesie im Rahmen eines balancierten Analgesiekonzeptes leisten.<\/jats:p>","DOI":"10.1055\/a-2754-3503","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T22:34:09Z","timestamp":1782513249000},"page":"379-391","source":"Crossref","is-referenced-by-count":0,"title":["Dexamethason zur perioperativen Analgesie"],"prefix":"10.1055","volume":"61","author":[{"given":"Sebastian","family":"Pantke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Leffler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam","family":"Eberhardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2200","DOI":"10.1038\/s41590-024-02002-9","article-title":"Immune drivers of pain resolution and protection","volume":"25","author":"S Hakim","year":"2024","journal-title":"Nat Immunol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1126\/science.aaf8924","article-title":"Pain regulation by non-neuronal cells and inflammation","volume":"354","author":"RR Ji","year":"2016","journal-title":"Science"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1038\/nrn3946","article-title":"Crosstalk between the nociceptive and immune systems in host defence and disease","volume":"16","author":"SB McMahon","year":"2015","journal-title":"Nat Rev Neurosci"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1361","DOI":"10.1038\/nn1992","article-title":"The neuropathic pain triad: neurons, immune cells and glia","volume":"10","author":"J Scholz","year":"2007","journal-title":"Nat Neurosci"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1902\/jop.2016.160353","article-title":"Comparison between dexamethasone and ibuprofen for postoperative pain prevention and control after surgical implant placement: a double-masked, parallel-group, placebo-controlled randomized clinical trial","volume":"88","author":"MA Bahammam","year":"2017","journal-title":"J Periodontol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1007\/s10006-012-0360-7","article-title":"Assessment of preemptive analgesia with ibuprofen coadministered or not with dexamethasone in third molar surgery: a randomized double-blind controlled clinical trial","volume":"17","author":"HC Bauer","year":"2013","journal-title":"Oral Maxillofac Surg"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2021-067325","article-title":"Effect of dexamethasone as an analgesic adjuvant to multimodal pain treatment after total knee arthroplasty: randomised clinical trial","volume":"376","author":"KS Gasbjerg","year":"2022","journal-title":"BMJ"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e141","DOI":"10.4317\/medoral.24088","article-title":"Is Dexamethasone superior to Ketorolac in reducing pain, swelling and trismus following mandibular third molar removal? 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