Effect of Low Dose Dexamethasone upon the Prevention of Postoperative Nausea and Vomiting after Thyroidectomy / 대한마취과학회지

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.