Dexamethasone prophylaxis before thyroidectomy to reduce postoperative nausea, pain, and vocal dysfunction: a randomized clinical controlled trial.
BACKGROUND
The objective of this 2-arm, double-blind, randomized, controlled study was to assess the effects of a preoperative single dose steroid on postoperative nausea and vomiting (PONV), pain, and vocal function after thyroidectomy for benign disease.


METHODS
We randomized 102 patients into 2 groups from January to December 2009: (1) treatment with 8 mg/2 mL of dexamethasone and (2) treatment with 2 mL NaCl 0.9%, both administered intravenously before anesthesia.


RESULTS
The severity of nausea and the need for antiemetic drugs were reduced in patients receiving dexamethasone (p = .0001). Dexamethasone patients reported significantly less pain (p = .008); the need for analgesic drugs was lower in the dexamethasone group (p = .048). No differences were noted with regard to subjective voice analysis (p = .693).


CONCLUSIONS
Dexamethasone (8 mg IV) is a safe and effective method to reduce PONV and pain after thyroid resection and should be used routinely.
Feroci
Francesco
F
General Surgery Unit, Misericordia and Dolce Hospital, Prato, Italy. fferoci@yahoo.it
Rettori
Marco
M
Borrelli
Andrea
A
Lenzi
Elisa
E
Ottaviano
Alessandra
A
Scatizzi
Marco
M
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003907:Dexamethasone / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods; D012016:Reference Values; D018570:Risk Assessment; D013959:Thyroid Diseases / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D014832:Voice Disorders / Q000453:epidemiology / Q000517:prevention & control*
D003907:Dexamethasone