Low-dose dexamethasone reduces nausea and vomiting after epidural morphine: a comparison of metoclopramide with saline.
OBJECTIVE
To compare the efficacy of a low dose of dexamethasone (5 mg) with metoclopramide 10 mg and saline in preventing nausea and vomiting after epidural morphine in posthysterectomy analgesia.


METHODS
Randomized, placebo-controlled study.


METHODS
Inpatient surgery at Municipal Women's and Children's General Hospital.


METHODS
120 ASA physical status I and II women receiving epidural morphine for posthysterectomy analgesia.


METHODS
All patients received epidural morphine 3 mg for postoperative analgesia. The dexamethasone group (n = 40) received dexamethasone 5 mg, the metoclopramide group (n = 40) received metoclopramide 10 mg, and the saline group (n = 40) received saline.


RESULTS
The occurrence of nausea and vomiting appeared more frequently during 6 to 24 hours following the administration of epidural morphine. The total frequency of nausea and vomiting in the dexamethasone group was significantly lower than that of the metoclopramide and saline groups during this period, with reporting frequencies of 21%, 49%, and 53%, respectively (p <.05 each). However, the difference between metoclopramide and saline did not reach statistical significance.


CONCLUSIONS
Dexamethasone 5 mg was more effective than metoclopramide or saline in the prevention of nausea and vomiting associated with epidural morphine for postoperative analgesia.
Tzeng
Jann Inn
JI
Department of Anesthesiology, Municipal Women's and Children's General Hospital, Kaohsiung.
Hsing
Chung Hsi
CH
Chu
Chin Chen
CC
Chen
Ying Hui
YH
Wang
Jhi Joung
JJ
D000328:Adult; D015360:Analgesia, Epidural; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D000932:Antiemetics / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008787:Metoclopramide / Q000008:administration & dosage*; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*
D000701:Analgesics, Opioid; D000932:Antiemetics; D009020:Morphine; D003907:Dexamethasone; D008787:Metoclopramide