Canadian Journal of Anaesthesia

, 48:973

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

  • Jeng-Chai Huang
  • Ja-Ping Shieh
  • Chao-Shun Tang
  • Jann-Inn Tzeng
  • Koung-Shing Chu
  • Jhi-Joung Wang
General Anesthesia

Abstract

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 receivediv dexamethasone 5 mg, whereas groups II and III receivediv 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 < 0.0l). Patients in group I reported a lower incidence of PONV than those in groups II (P < 0.05) and III (P < 0.0l) 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

Prophylacticiv 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.

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

Résumé

Objectif

Évaluer l’effet prophylactique d’une faible dose de dexaméthasone (5 mg) sur les nausées et vomissements postopératoires (NVPO) chez des patientes de chirurgie laparoscopique ambulatoire. Le métoclopramide et une solution salée ont servi de témoins.

Méthode

Cent vingt femmes (n = 40 dans chacun des trois groupes formés de façon aléatoire), devant subir une ligature des trompes sous anesthésle générale en chirurgie laparoscopique ambulatoire, ont participé à l’étude randomisée, en double Insu et contrôlée contre placebo. Après l’intubation endotrachéale, les patientes du groupe I ont reçu 5 mg de dexaméthasone iv tandis que celles des groupes II et III ont reçu 10 mg de métoclopramide ou de solution salée iv, respectivement.

Résultats

Les patientes du groupe I ont signalé une plus faible Incidence de NVPO et ont demandé moins d’antiémétiques de secours que les patientes du groupe III pendant les quatre premières heures postopératoires (P < 0,01). Les patients du groupe I ont eu moins de NVPO que celles des groupes II (P < 0,05) et III (P < 0,01) pendant une période de 24 h après l’intervention. Aucune différence intergroupe quant à l’incidence de NVPO et au nombre de patientes qui ont eu recours aux antiémétiques n’a été notée entre les patientes des groupes II et III.

Conclusion

L’administration iv de 5 mg de dexaméthasone réduit significativement l’incidence de NVPO chez des patientes qui subissent une ligature des trompes en chirurgie laparoscopique ambulatoire. Cést plus efficace que 10 mg de métoclopramide ou de placebo.

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Copyright information

© Canadian Anesthesiologists 2001

Authors and Affiliations

  • Jeng-Chai Huang
    • 1
  • Ja-Ping Shieh
    • 2
  • Chao-Shun Tang
    • 3
  • Jann-Inn Tzeng
    • 3
  • Koung-Shing Chu
    • 3
  • Jhi-Joung Wang
    • 2
  1. 1.Department of Medical ResearchChi-Mei Medical CenterTainan
  2. 2.Department of AnesthesiologyChi-Mei Medical CenterTainanTaiwan
  3. 3.Department of AnesthesiologyKaohsiung Medical UniversityKaohsiungTaiwan

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