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

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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.

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Acknowledgments

The authors Chia-Che Chen, Fahad Javaid Siddiqui, Ta-Liang Chen, Edwin Shih-Yen Chan, and Ka-Wai Tam have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Division of General Surgery, Department of Surgery, Taipei Medical University Hospital, 252 Wuxing Street, Taipei, 11031, Taiwan

    Chia-Che Chen & Ka-Wai Tam

  2. Department of Anesthesiology, Taipei Medical University, Taipei, Taiwan

    Ta-Liang Chen

  3. Department of Epidemiology, Duke–NUS Graduate Medical School and Singapore Clinical Research Institute, Singapore, Singapore

    Fahad Javaid Siddiqui & Edwin Shih-Yen Chan

Authors
  1. Chia-Che Chen
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  2. Fahad Javaid Siddiqui
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  3. Ta-Liang Chen
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Corresponding author

Correspondence to Ka-Wai Tam.

Additional information

Chia-Che Chen and Fahad Javaid Siddiqui contributed equally to this work.

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Chen, CC., Siddiqui, F.J., Chen, TL. et al. Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Patients Undergoing Thyroidectomy: Meta-analysis of Randomized Controlled Trials. World J Surg 36, 61–68 (2012). https://doi.org/10.1007/s00268-011-1343-9

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  • DOI: https://doi.org/10.1007/s00268-011-1343-9

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