Prevention of PONV with dexamethasone in female patients undergoing desflurane anesthesia for thyroidectomy.
BACKGROUND
Desflurane is associated with a higher incidence of 24-h postoperative nausea and vomiting (PONV) as compared with sevoflurane or isoflurane. Dexamethasone 5 mg i.v. is suggested to be the minimum effective dose for prophylaxis of PONV in women undergoing thyroidectomy with isoflurane anesthesia. The objective of this study was to investigate whether a 5 mg dose of dexamethasone could be enough for, or a larger dose at 8 mg, could be more capable of preventing PONV in women undergoing desflurane anesthesia for thyroidectomy.


METHODS
One hundred and thirty five patients were assigned to receive one of three treatment regimens prior to induction i.e., dexamethasone 8 mg i.v. (Group D8), dexamethesone 5 mg i.v. (Group D5) or saline (Group S).


RESULTS
It was demonstrated that the prophylactic administration of either dexamethasone 8 mg or 5 mg significantly reduced the overall incidence of PONV in patients undergoing thyroidectomy with desflurane anesthesia (P < 0.001, Group D8 vs. Group S; Group D5 vs. Group S). However, patients who received dexamethasone 8 mg showed a higher incidence of complete responses (no vomiting or need of rescue antiemetic medication for a 24-h postoperative period) in comparison with those receiving dexamethasone 5 mg (86% vs. 67%; P < 0.01).


CONCLUSIONS
The results of this study showed that in PONV prophylaxis, in female patients undergoing desflurane anesthesia for thyroidectomy, the effect of dexamethasone 8 mg was superior to that of dexamethasone 5 mg.
Lee
Y
Y
Department of Anesthesiology, Buddhist Tzu Chi General Hospital, No 707, Section 3, Chung Yang Road, Hualien, Taiwan, R.O.C. drleeyi@sinamail.com
Lin
P C
PC
Lai
H Y
HY
Huang
S J
SJ
Lin
Y S
YS
Cheng
C R
CR
D000328:Adult; D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D000932:Antiemetics / Q000627:therapeutic use*; D000077335:Desflurane; D003907:Dexamethasone / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007530:Isoflurane / Q000031:analogs & derivatives / Q000494:pharmacology*; D008875:Middle Aged; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D013965:Thyroidectomy
D018685:Anesthetics, Inhalation; D000932:Antiemetics; D003907:Dexamethasone; D000077335:Desflurane; D007530:Isoflurane