World Journal of Surgery

, Volume 36, Issue 1, pp 61–68

Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Patients Undergoing Thyroidectomy: Meta-analysis of Randomized Controlled Trials

  • Chia-Che Chen
  • Fahad Javaid Siddiqui
  • Ta-Liang Chen
  • Edwin Shih-Yen Chan
  • Ka-Wai Tam
Article

DOI: 10.1007/s00268-011-1343-9

Cite this article as:
Chen, CC., Siddiqui, F.J., Chen, TL. et al. World J Surg (2012) 36: 61. doi:10.1007/s00268-011-1343-9

Abstract

Background

Postoperative nausea and vomiting (PONV) is a common complication after thyroidectomy. Steroids effectively reduce nausea, pain, and inflammation; therefore, preoperative administration of steroids ought to improve these surgical outcomes.

Methods

We conducted a systematic review of randomized controlled trials (RCTs) that compared preoperative single-dose administration of dexamethasone with no dexamethasone in patients undergoing thyroidectomy. The primary outcome was occurrence of PONV within 24 h, and the secondary outcomes were pain, use of analgesics, and steroid-related complications.

Results

Five RCTs were included with a total of 497 patients. A statistically and clinically significant difference in the incidence of PONV was found in favor of dexamethasone [relative risk (RR) 0.38; 95% confidence interval (CI) 0.30–0.49). The visual analog pain score was significantly diminished (weighted mean difference, WMD)–1.50; 95% CI–2.54 to –0.46) at 24 h. The incidence of analgesics use was also reduced (RR 0.61; 95% CI 0.41–0.90) in the dexamethasone group. No steroid-related complications were noted.

Conclusions

A single preoperative administration of dexamethasone reduced the incidence of PONV and analgesic requirements in patients undergoing thyroidectomy. Prophylactic use of steroids for patients undergoing thyroidectomy is safe and should be considered for routine clinical practice.

Copyright information

© Société Internationale de Chirurgie 2011

Authors and Affiliations

  • Chia-Che Chen
    • 1
  • Fahad Javaid Siddiqui
    • 3
  • Ta-Liang Chen
    • 2
  • Edwin Shih-Yen Chan
    • 3
  • Ka-Wai Tam
    • 1
  1. 1.Division of General Surgery, Department of SurgeryTaipei Medical University HospitalTaipeiTaiwan
  2. 2.Department of AnesthesiologyTaipei Medical UniversityTaipeiTaiwan
  3. 3.Department of EpidemiologyDuke–NUS Graduate Medical School and Singapore Clinical Research InstituteSingaporeSingapore

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