Effect of Low Dose Dexamethasone upon the Prevention of Postoperative Nausea and Vomiting after Thyroidectomy. |
Suk Joo Seo, Kyung Han Kim |
Department of Anesthesiology and Pain Medicine, College of Medicine, Kosin University, Busan, Korea. kimkh@kosinmed.or.kr |
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Abstract |
BACKGROUND Postoperative nausea and vomiting (PONV) are common and unpleasant experiences. Several studies have demonstrated that dexamethasone has a potent antiemetic effect for the prophylaxis of PONV, and that dexamethasone is beneficial in the management of acute surgical pain because of its potent anti-inflammatory effect. In this randomized study, we evaluated the effect of dexamethasone 5 mg on PONV and pain in 73 patients after thyroidectomy. METHODS Dexamethasone 5 mg or saline 2 ml was IV administered in a randomized manner immediately after the induction of anesthesia in each group. Patients were assessed for the incidence of PONV at 6 h and 24 h after surgery, rescue antiemetics, total amount of analgesic, time to first analgesic demand, and VAS pain score at 6 h after surgery. The occurrence of side effects, such as, wound infection or delayed wound healing, and the duration of hospital stay were recorded. RESULTS The incidence (21.1%, 8/38) of PONV in the dexamethasone group was significantly lower than (71.4%, 25/35) in the saline group during the 6 h postoperative period (P<0.05). PONV occurred in 7.9% of patients in the dexamethasone group and in 51.4% of patients in the saline group during the 6-24 h postoperative period. The proportion (7.9%) of patients requiring antiemetics was significantly lower in the dexamethasone group than in the saline group (25.7%) at 24 h postoperatively. The incidence of analgesic use, the total amount of analgesic and the VAS pain score were not significantly different in the two groups. No discernible side effects were found. CONCLUSIONS Dexamethasone 5 mg was effective at preventing PONV after thyroidectomy, but it had no effect on postoperative pain. |
Key Words:
antiemetic; dexamethasone; postoperative nausea and vomiting (PONV) |
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