title: Dexamethasone is as effective as ondansetron for the prevention of postoperative nausea and vomiting following breast surgery.
abstract: BACKGROUND
  Postoperative nausea and vomiting remain a common problem following breast surgery. This study assesses whether dexamethasone is as effective as ondansetron in the control of postoperative nausea and vomiting (PONV).
  
  
  METHODS
  Eighty ASA I-III patients undergoing breast surgery for carcinoma of the breast were included in the study. Following premedication with diazepam 5-10 mg, patients were induced with fentanyl 50 micro g and propofol 2-2.5 mg kg-1. A larynx mask was inserted and anesthesia maintained with sevoflurane in oxygen and nitrous oxide. Patients were then randomly divided into two groups: Group D (dexamethasone) was given 4 mg dexamethasone i.v. after induction and Group O (ondansetron) was given 4 mg ondansetron at the same time point. Postoperatively, nausea, vomiting and pain were recorded at 1-h intervals during 4 h, and thereafter every 4 h during 24 h.
  
  
  RESULTS
  The incidence of PONV during 24 h was 37% and 33% in Group D and Group O, respectively (NS). No differences were found between the groups in the incidence of postoperative nausea, vomiting or pain at the different time intervals. No differences were found in the incidence of PONV in smokers vs. non-smokers. No side-effects of these drugs were observed.
  
  
  CONCLUSIONS
  Ondansetron 4 mg or dexamethasone 4 mg are equally effective in the prevention of postoperative nausea and vomiting following breast surgery. Other factors being similar, the difference in cost between these drugs would favor the use of dexamethasone instead of ondansetron when monotherapy against PONV is used.
authors.affiliation: Department of Anesthesiology and Intensive Care, University Hospital, Orebro, Sweden. magnus.wattwil@orebroll.se
authors.forename: M
authors.initials: M
authors.lastname: Wattwil
authors.forename: S-E
authors.initials: SE
authors.lastname: Thörn
authors.forename: A
authors.initials: A
authors.lastname: Lövqvist
authors.forename: L
authors.initials: L
authors.lastname: Wattwil
authors.forename: A
authors.initials: A
authors.lastname: Gupta
authors.forename: G
authors.initials: G
authors.lastname: Liljegren
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000627:therapeutic use; D001940:Breast / Q000473:pathology / Q000601:surgery*; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery; D003907:Dexamethasone / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017294:Ondansetron / Q000627:therapeutic use*; D010147:Pain Measurement; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D012907:Smoking; D018709:Statistics, Nonparametric
chemical_list: D000932:Antiemetics; D017294:Ondansetron; D003907:Dexamethasone