Dexamethasone prevents postoperative nausea and vomiting more effectively in women with motion sickness.
OBJECTIVE
To evaluate the antiemetic effect of iv dexamethasone for preventing postoperative nausea and vomiting (PONV) in women with and without a history of motion sickness.


METHODS
This randomized, double-blinded, placebo-controlled study was carried out in 168 female patients with (n = 84) and without (n = 84) a history of motion sickness undergoing gynecological laparoscopy. Patients received 8 mg dexamethasone or saline immediately before induction of anesthesia. Postoperatively patients were assessed for 24 hr for nausea, vomiting, and complete response (no vomiting, no need for rescue antiemetics).


RESULTS
The complete response for patients with a history of motion sickness was 80.5% and 37.5% for recipients of dexamethasone and saline, respectively [P < 0.001; number needed-to-treat (NNT) = 2.3]; with corresponding incidences of 83.3% and 53.7% when there was no such history (P = 0.009; NNT = 3.4). Calculation of the efficacy of dexamethasone for the different subgroups shows that dexamethasone was 45.3% more effective in patients with motion sickness than in those without it.


CONCLUSIONS
Prophylactic administration of dexamethasone is effective in reducing PONV in patients with and without a history of motion sickness. The results of this study were more favourable in patients with a history of motion sickness, demonstrating a higher effectiveness of dexamethasone for preventing PONV in this subgroup of patients.
Lee
Yi
Y
Department of Anesthesiology, Tzu-Chi Medical Center, Hualien, Taiwan, R.O.C. drleeyi@sinamail.com
Lai
Hsien-Yong
HY
Lin
Pei-Chin
PC
Huang
Shen-Jer
SJ
Lin
Youh-Sheng
YS
D000328:Adult; D000932:Antiemetics / Q000627:therapeutic use*; D003907:Dexamethasone / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008875:Middle Aged; D009041:Motion Sickness / Q000517:prevention & control*; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D012702:Serotonin Antagonists / Q000627:therapeutic use
D000932:Antiemetics; D012702:Serotonin Antagonists; D003907:Dexamethasone