title: Reduction of postoperative nausea, vomiting, and analgesic requirement with dexamethasone for patients undergoing laparoscopic cholecystectomy.
abstract: BACKGROUND
  Dexamethasone has antiemetic and analgesic effects for various types of surgery. The efficacy of dexamethasone for reducing postoperative nausea and vomiting (PONV) and analgesic requirement has never been evaluated for patients undergoing laparoscopic cholecystectomy (LC).
  
  
  METHODS
  In a prospective, randomized, double-blind, placebo-controlled study, patients intravenously received placebo, dexamethasone 4 mg, or dexamethasone 8 mg immediately before induction of anesthesia. A standard anesthetic technique, including sevoflurane and air in oxygen, was used. Postoperatively, emetic symptoms (nausea, retching, and vomiting) and analgesic requirement were evaluated by an investigator.
  
  
  RESULTS
  The study enrolled 90 patients (38 men and 52 nonpregnant women), with each treatment group comprising 30 patients. The rate of patients experiencing PONV 0-24 h after anesthesia was 60% for the dexamethasone 4 mg group (p = 0.294) and 33% for the dexamethasone 8 mg group (p = 0.01), compared with 70% for the placebo group. The need for indomethacin to relieve intolerable pain was less in the dexamethasone 8 mg group than in the placebo group (p = 0.008) or the dexamethasone 4 mg group (p = 0.029). No difference in analgesic requirement was found between the dexamethasone 4 mg group and the placebo group (p = 0.395). No clinically important adverse effects due to the study drug were observed in any group.
  
  
  CONCLUSIONS
  Prophylactic therapy with dexamethasone 8 mg is effective in reducing PONV and analgesic requirement for patients undergoing LC.
authors.affiliation: Department of Anesthesiology, Ushiku Aiwa General Hospital, Ibaraki, Japan. yfujii@med.toho-u.ac.jp
authors.forename: Y
authors.initials: Y
authors.lastname: Fujii
authors.forename: M
authors.initials: M
authors.lastname: Itakura
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D000704:Analysis of Variance; D000932:Antiemetics / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D017081:Cholecystectomy, Laparoscopic; D003907:Dexamethasone / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D000932:Antiemetics; D010919:Placebos; D003907:Dexamethasone
references.citation: Endocr Rev. 2000 Feb;21(1):55-89
references.pmid: 10696570
references.citation: Can J Anaesth. 1994 Sep;41(9):798-801
references.pmid: 7954996
references.citation: Br J Cancer. 1992 May;65(5):779-80
references.pmid: 1586608
references.citation: Acta Anaesthesiol Scand. 2003 Aug;47(7):823-7
references.pmid: 12859302
references.citation: Anesth Analg. 2002 Jul;95(1):229-32, table of contents
references.pmid: 12088975
references.citation: Drugs. 2000 Feb;59(2):213-43
references.pmid: 10730546
references.citation: Br J Anaesth. 1999 Nov;83(5):772-5
references.pmid: 10690141
references.citation: Can J Anaesth. 1996 Mar;43(3):226-31
references.pmid: 8829860
references.citation: J Am Coll Surg. 2002 Nov;195(5):694-712
references.pmid: 12437261
references.citation: N Engl J Med. 1981 Aug 27;305(9):520
references.pmid: 7195983
references.citation: J Clin Oncol. 1984 May;2(5):466-71
references.pmid: 6539363
references.citation: Masui. 1995 Dec;44(12):1627-31
references.pmid: 8583657
references.citation: Br J Surg. 2006 Mar;93(3):295-9
references.pmid: 16400707
references.citation: Anaesthesia. 1993 Nov;48(11):961-4
references.pmid: 8250191
references.citation: Anesth Analg. 2000 Jan;90(1):186-94
references.pmid: 10625002
references.citation: J Neurol. 1985;231(6):336-9
references.pmid: 3855968
references.citation: Anesthesiology. 1992 Jul;77(1):162-84
references.pmid: 1609990