The influence of dexamethasone on postoperative nausea and vomiting in patients undergoing gynecologic laparoscopic surgeries: A randomised, controlled, double blind trial

Abstract

Objective:Dexamethasone, as a part of multimodal approach, can decrease nausea and vomiting following laparoscopy in high risk patients. We performed this study to find out whether the dexamethasone can improve postoperative nausea and vomiting (PONV) in patients undergoing gynecology laparoscopic surgeries.Materials and Methods:In this double-blind randomized clinical trial, 91 patients who underwent gynecologic laparoscopic surgery in Rasool Akram hospital in Tehran during 2011-2014 were enrolled. Fourty-four patients received 8 mg dexamethasone (study group) and 47 patients received 10 mg metochlopramide (control group) intravenously after intubation. Outcome parameters including age, weight, height, cause of hospitalization, drugs, Last Menstrual Period (LMP), Blood Pressure (BP), Heart Rate (HR), Respiratory Rate (RR) and oxygen saturation, Visual Analogue Scale (VAS) score, nausea and vomiting were entered to SPSS (v.16) and were analyzed.Results:Eighyt-eight American Society of Anesthesiology (ASA) class 1-2 patients between 25-39 years old were analyzed. There was no difference in vital signs during and post operation (BP, HR, RR and O2 saturation) between these two groups (p value>0.05).There was no significant difference between VAS score at 4 and 24 hours after the operation (14% vs. 17.8% and 7% vs. 6.7%, respectively, p>0.05). Incidence of PONV in 4 hours was significantly lower in dexamethasone group (11.6% vs. 55.6% p<0.0001), while there was no significant difference in 24 hours (23.3% vs. 22.2%, p>0.05) and also need to anti-emetic drugs wasn’t significantly lower in study group (p>0.05).Conclusion:We conclude that dexamethasone can relieve PONV after gynecologic laparoscopic surgery.

A web‐based dynamic predictive model for postoperative nausea and vomiting in patient receiving gynecological laparoscopic surgery

“…Some studies reported that dexamethasone and 5-HT3 receptor antagonists can reduce the risk of PONV. [50][51][52] However, this finding was not significant in the present study. This may be attributed to the small dose of dexamethasone used in our study (3-10 mg).…”

Comparison of intraperitoneal versus intravenous dexamethasone on postoperative nausea and vomiting after gynecological laparoscopy: a randomized clinical trial

“…Sample size calculation was based on the study of Asadollah et al [14] who reported that the incidence of PONV in patients undergoing gynecological laparoscopy and who received IV dexamethasone was 39.9%. We considered a reduction of the incidence of PONV to 10% in the first 24 h postlaparoscopy as significant.…”

What is the impact of dexamethasone on postoperative pain in adults undergoing general anaesthesia for elective abdominal surgery: a systematic review and meta-analysis

“…Studies failed to meet the inclusion criteria and were excluded for the following reasons; 23 articles reported no pain outcomes, three studies were not RCTs, two studies had mixed surgical cohorts, participants did not receive general anaesthesia in three studies, there was no intravenous comparator in four studies and in one the analgesic effect of dexamethasone could not be isolated. Seven studies with minor surgery were excluded [29][30][31][32][33][34][35] . A further 12 studies were excluded; two used an alternative method of pain assessment and 10 presented inadequate data for analysis that we were unable to obtain through contacting the authors.…”