The effect of dexamethasone on the longevity of syringe driver subcutaneous sites in palliative care patients

Objective: To assess the effect of adding 1 mg dexamethasone to syringe drivers on the viability time of subcutaneous cannulation sites in palliative care patients. Design: Prospective, double-blind, randomised, controlled trial in which patients received half their daily infused medications plus 1 mg dexamethasone in 1 mL saline through one subcutaneous site (test site) and the other half of their medications plus 1 mL saline through another symmetrically placed site (control site). Participants and setting. Palliative care patients from the inpatient units at two hospices, recruited between 1999 and 2002. Main outcome measure: Difference in time that the test and control sites remained viable. Results: 38 patents consented and were randomised. Twenty did not complete the trial because their participation in the study finished before either site broke down, Eighteen patents either partially completed (at least one site broke down) or fully completed (both sites broke down) the trial. In these 18 patients, test sites lasted 3.6 days longer than control sites (95% CI, 1.6-5.8 days; P=0.002). Twelve patents fully completed the trial. In this group, test sites lasted 3.9 days longer than control sites (95% CI, 0.6-7.2 days; P=0.025). Conclusions: The addition of 1 mg dexamethasone to syringe drivers significantly extends the viability time of subcutaneous cannulation sites in palliative care patients.