Low-dose dexamethasone reduces nausea and vomiting after tympanomastoid surgery: a comparison of tropisetron with saline.
OBJECTIVE
The aim of the study was to evaluate the efficacy of low-dose dexamethasone sodium phosphate (5 mg) on the prophylaxis of nausea and vomiting after tympanomastoid surgery. Tropisetron hydrochloride (2 mg) and saline were used as controls.


METHODS
One hundred twenty patients (n = 40 in each of 3 groups) undergoing general anesthesia for tympanomastoid surgery were enrolled in this randomized, double-blind, placebo-controlled study. Following endotracheal intubation, group 1 received intravenous dexamethasone 5 mg, whereas groups 2 and 3 received intravenous 2 mg tropisetron and saline, respectively. Several parameters connected with the occurrence of postoperative nausea and vomiting were evaluated.


RESULTS
Dexamethasone 5 mg significantly reduced the total incidence of nausea and vomiting by 40% (P =.002). Dexamethasone also reduced the incidence of vomiting episodes by more than 4-fold (P =.03) and the incidence of patients requiring rescue antiemetics (P =.02). Tropisetron at a 2-mg dose did not exhibit any significant antiemetic effect.


CONCLUSIONS
Dexamethasone sodium phosphate 5 mg was more effective than 2 mg tropisetron hydrochloride and saline in the prevention of nausea and vomiting after tympanomastoid surgery.
Wang
Jhi-Joung
JJ
Departments of Anesthesiology and Otolaryngology, Cathay General Hospital, Taipei.
Wang
Pa-Chun
PC
Liu
Yun-Hou
YH
Chien
Chih-Cheng
CC
D000328:Adult; D000932:Antiemetics / Q000008:administration & dosage* / Q000627:therapeutic use*; D003907:Dexamethasone / Q000008:administration & dosage* / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D007275:Injections, Intravenous; D008297:Male; D008416:Mastoid / Q000601:surgery*; D008875:Middle Aged; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D000077526:Tropisetron; D014433:Tympanoplasty / Q000009:adverse effects*
D000932:Antiemetics; D007211:Indoles; D000077526:Tropisetron; D003907:Dexamethasone