title: Randomized clinical trial of the effect of preoperative dexamethasone on nausea and vomiting after laparoscopic cholecystectomy.
abstract: BACKGROUND
  Preoperative dexamethasone may reduce disabling symptoms such as pain, nausea and vomiting after laparoscopic cholecystectomy.
  
  
  METHODS
  This was a randomized, double-blind, placebo-controlled trial. Between March and December 2004, 101 patients undergoing laparoscopic cholecystectomy were randomized to receive 8 mg dexamethasone (n = 49) or placebo (n = 52) intravenously before surgery. Six patients were excluded from the study. All patients received a standardized anaesthetic, surgical and multimodal analgesic treatment. The primary endpoints were: first, postoperative nausea, vomiting and pain; second, postoperative analgesic and antiemetic requirements. The pain scores (visual analogue and verbal response scales), the episodes of nausea (verbal response scale) and vomiting were recorded at 1, 3, 6 and 24 h, respectively, after the operation. Analgesic and antiemetic requirements were also recorded.
  
  
  RESULTS
  No apparent drug side-effects were noted. Seven patients (14 per cent) in the treatment group reported nausea and vomiting compared with 24 (46 per cent) in the control group (P = 0.001). In the group of patients treated with dexamethasone, five (10 per cent) required antiemetics versus 23 (44 per cent) of those receiving placebo (P < 0.001). No difference in postoperative pain scores and analgesic requirements was detected between groups.
  
  
  CONCLUSIONS
  Preoperative dexamethasone reduces postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy, with no side-effects, and may be recommended for routine use.
authors.affiliation: Section of General Surgery, Department of Surgery, Anaesthesiology and Radiology, University of Ferrara, Ferrara, Italy. cvfeo@unife.it
authors.forename: C V
authors.initials: CV
authors.lastname: Feo
authors.forename: D
authors.initials: D
authors.lastname: Sortini
authors.forename: R
authors.initials: R
authors.lastname: Ragazzi
authors.forename: M
authors.initials: M
authors.lastname: De Palma
authors.forename: A
authors.initials: A
authors.lastname: Liboni
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D000932:Antiemetics / Q000627:therapeutic use*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D003907:Dexamethasone / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005705:Gallbladder Diseases / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D017060:Patient Satisfaction; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D000932:Antiemetics; D003907:Dexamethasone