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Low-dose dexamethasone effectively prevents postoperative nausea and vomiting after ambulatory laparoscopic surgery

[Une faible dose de dexaméthasone prévient efficacement les nausées et les vomissements postopératoires en chirurgie laparoscopique ambulatoire]

Jeng-Chai Huang, PhD^*, Ja-Ping Shieh, MD MS, Chao-Shun Tang, PhD, Jann-Inn Tzeng, MD, Koung-Shing Chu, MD and Jhi-Joung Wang, MD DMS^*,

^* From the Department of Medical Research, and Anesthesiology,
Chi-Mei Medical Center, Tainan; and the Department of Anesthesiology,
Kaohsiung Medical University, Kaohsiung, Taiwan.

Dr. Jhi-Joung Wang, Department of Anesthesiology, Chi-Mei Medical Center, Tainan, Taiwan. Phone: 886-6-2517844; Fax: 886-6-2832639; E-mail: 400003{at}mail.chimei.org.tw

Purpose: To evaluate the prophylactic effect of low-dose dexamethasone (5 mg) on postoperative nausea and vomiting (PONV) in women undergoing ambulatory laparoscopic surgery. Metoclopramide and saline served as controls.

Methods: One hundred twenty women (n=40 in each of the three groups) undergoing ambulatory laparoscopic tubal ligation under general anesthesia were enrolled in this randomized, double-blinded, placebo-controlled study. After tracheal intubation, group I received iv dexamethasone 5 mg, whereas groups II and III received iv metoclopramide 10 mg and saline, respectively.

Results: Patients in group I reported a lower incidence of PONV and requested less rescue antiemetics than those in group III during the first four postoperative hours (P <0.01). Patients in group I reported a lower incidence of PONV than those in groups II (P <0.05) and III (P <0.01) during the 24-hr postoperative period. Groups II and III did not differ from each other in the incidence of PONV and the proportion of patients who requested rescue antiemetics.

Conclusion: Prophylactic iv dexamethasone 5 mg significantly reduces the incidence of PONV in women undergoing ambulatory laparoscopic tubal ligation. At this dose, dexamethasone is more effective than metoclopramide 10 mg or placebo.

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