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Dexamethasone prevents postoperative nausea and vomiting more effectively in women with motion sickness

[La dexaméthasone prévient plus efficacement les nausées et les vomissements postopératoires chez les femmes atteintes du mal des transports]

From the Department of Anesthesiology, Tzu-Chi Medical Center, Hualien, Taiwan, R.O.C.

Address correspondence to: Dr. Yi Lee, Department of Anesthesiology, Tzu-Chi Medical Center, No. 707, Sec. 3, Chung-Yang Road, Hualien, Taiwan, R.O.C. E-mail: drleeyi{at}sinamail.com

Purpose: To evaluate the antiemetic effect of iv dexamethasone for preventing postoperative nausea and vomiting (PONV) in women with and without a history of motion sickness.

Methods: This randomized, double-blinded, placebo-controlled study was carried out in 168 female patients with (n = 84) and without (n = 84) a history of motion sickness undergoing gynecological laparoscopy. Patients received 8 mg dexamethasone or saline immediately before induction of anesthesia. Postoperatively patients were assessed for 24 hr for nausea, vomiting, and complete response (no vomiting, no need for rescue antiemetics).

Results: The complete response for patients with a history of motion sickness was 80.5% and 37.5% for recipients of dexamethasone and saline, respectively [P < 0.001; number needed-to-treat (NNT) = 2.3]; with corresponding incidences of 83.3% and 53.7% when there was no such history (P = 0.009; NNT = 3.4). Calculation of the efficacy of dexamethasone for the different subgroups shows that dexamethasone was 45.3% more effective in patients with motion sickness than in those without it.

Conclusions: Prophylactic administration of dexamethasone is effective in reducing PONV in patients with and without a history of motion sickness. The results of this study were more favourable in patients with a history of motion sickness, demonstrating a higher effectiveness of dexamethasone for preventing PONV in this subgroup of patients.

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				J. Golembiewski, E. Chernin, and T. Chopra Prevention and treatment of postoperative nausea and vomiting Am. J. Health Syst. Pharm., June 15, 2005; 62(12): 1247 - 1260. [Abstract] [Full Text] [PDF]