This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (39) Citing Articles via Google Scholar Google Scholar Articles by Liu, K. Articles by Chia, Y.-Y. Search for Related Content PubMed PubMed Citation Articles by Liu, K. Articles by Chia, Y.-Y.

---

GENERAL ARTICLES

The Effective Dose of Dexamethasone for Antiemesis after Major Gynecological Surgery

Department of Anesthesia, Veterans General Hospital-Kaohsiung, National Yang-Ming University, School of Medicine, Taiwan, Republic of China

Address correspondence and reprint requests to Yuan-Yi Chia, MD, Department of Anesthesia, Veterans General Hospital-Kaohsiung, Taiwan, Republic of China.

This double-blind, randomized, placebo-controlled study evaluated the minimum effective dose of dexamethasone for postoperative antiemesis. One-hundred fifty women scheduled for major gynecological surgery were randomly assigned to receive dexamethasone 10 mg (D10), 5 mg (D5), 2.5 mg (D2.5), 1.25 mg (D1.25), or placebo (P) before the induction of general anesthesia. A standardized general anesthesia technique was used. Postoperative pain was treated with bolus IV doses of morphine via a patient-controlled analgesia device. Patients were assessed for incidence of vomiting at 4, 8, 12, and 24 h after surgery. A total of 6, 6, 8, 15, and 19 patients in Groups D10, D5, D2.5, D1.25, and Group P experienced vomiting at least once within the first postoperative 24 h, respectively. Dexamethasone 10 mg, 5 mg, and 2.5 mg was more effective than dexamethasone 1.25 mg or placebo for antiemesis (P < 0.05). The difference in antiemetic effect among the 10 mg, 5 mg, and 2.5 mg groups was similar. The results suggest that 2.5 mg is the minimum effective dose of dexamethasone for postoperative antiemesis in patients undergoing general anesthesia for major gynecological surgery.

Implications: Although dexamethasone is effective for antiemesis, major side effects may accompany its perioperative use. To achieve the best antiemesis with the fewest side effects, dexamethasone 10 mg, 5 mg, 2.5 mg, and 1.25 mg were compared with placebo in surgical patients. We found 2.5 mg to be the minimum effective dose without discernible side effects.

This article has been cited by other articles:

				R. M. Jokela, J. V. Ahonen, M. K. Tallgren, P. C. Marjakangas, and K. T. Korttila The Effective Analgesic Dose of Dexamethasone After Laparoscopic Hysterectomy Anesth. Analg., August 1, 2009; 109(2): 607 - 615. [Abstract] [Full Text] [PDF]

				K. J. Kardash, F. Sarrazin, M. J. Tessler, and A. M. Velly Single-Dose Dexamethasone Reduces Dynamic Pain After Total Hip Arthroplasty Anesth. Analg., April 1, 2008; 106(4): 1253 - 1257. [Abstract] [Full Text] [PDF]

				M. S. Kim, C. J. Cote, C. Cristoloveanu, A. G. Roth, P. Vornov, M. A. Jennings, J. P. Maddalozzo, and C. Sullivan There Is No Dose-Escalation Response to Dexamethasone (0.0625-1.0 mg/kg) in Pediatric Tonsillectomy or Adenotonsillectomy Patients for Preventing Vomiting, Reducing Pain, Shortening Time to First Liquid Intake, or the Incidence of Voice Change Anesth. Analg., May 1, 2007; 104(5): 1052 - 1058. [Abstract] [Full Text] [PDF]

				M. J. Paech, M. W.M. Rucklidge, J. Lain, P. H. Dodd, E.-J. Bennett, and D. A. Doherty Ondansetron and Dexamethasone Dose Combinations for Prophylaxis Against Postoperative Nausea and Vomiting Anesth. Analg., April 1, 2007; 104(4): 808 - 814. [Abstract] [Full Text] [PDF]

				S. M Wilhelm, M. L Dehoorne-Smith, and P. B Kale-Pradhan Prevention of Postoperative Nausea and Vomiting Ann. Pharmacother., January 1, 2007; 41(1): 68 - 78. [Abstract] [Full Text] [PDF]

				A. Salerno and R. Hermann Efficacy and Safety of Steroid Use for Postoperative Pain Relief. Update and Review of the Medical Literature J. Bone Joint Surg. Am., June 1, 2006; 88(6): 1361 - 1372. [Abstract] [Full Text] [PDF]

				J. Golembiewski, E. Chernin, and T. Chopra Prevention and treatment of postoperative nausea and vomiting Am. J. Health Syst. Pharm., June 15, 2005; 62(12): 1247 - 1260. [Abstract] [Full Text] [PDF]

				R. Madan, A. Bhatia, S. Chakithandy, R. Subramaniam, G. Rammohan, S. Deshpande, M. Singh, and H. L. Kaul Prophylactic Dexamethasone for Postoperative Nausea and Vomiting in Pediatric Strabismus Surgery: A Dose Ranging and Safety Evaluation Study Anesth. Analg., June 1, 2005; 100(6): 1622 - 1626. [Abstract] [Full Text] [PDF]

				C. C. Apfel, K. Korttila, M. Abdalla, H. Kerger, A. Turan, I. Vedder, C. Zernak, K. Danner, R. Jokela, S. J. Pocock, et al. A Factorial Trial of Six Interventions for the Prevention of Postoperative Nausea and Vomiting N. Engl. J. Med., June 10, 2004; 350(24): 2441 - 2451. [Abstract] [Full Text] [PDF]

				T. J. Gan, T. Meyer, C. C. Apfel, F. Chung, P. J. Davis, S. Eubanks, A. Kovac, B. K. Philip, D. I. Sessler, J. Temo, et al. Consensus Guidelines for Managing Postoperative Nausea and Vomiting Anesth. Analg., July 1, 2003; 97(1): 62 - 71. [Abstract] [Full Text] [PDF]

				R. Thomas and N. Jones Prospective randomized, double-blind comparative study of dexamethasone, ondansetron, and ondansetron plus dexamethasone as prophylactic antiemetic therapy in patients undergoing day-case gynaecological surgery Br. J. Anaesth., October 1, 2001; 87(4): 588 - 592. [Abstract] [Full Text] [PDF]

				M. T. Aouad, S. S. Siddik, L. B. Rizk, G. M. Zaytoun, and A. S. Baraka, MD The Effect of Dexamethasone on Postoperative Vomiting After Tonsillectomy Anesth. Analg., March 1, 2001; 92(3): 636 - 640. [Abstract] [Full Text] [PDF]

				P.-H. Tan, K. Liu, C.-H. Peng, L.-C. Yang, C.-R. Lin, and C.-Y. Lu The Effect of Dexamethasone on Postoperative Pain and Emesis After Intrathecal Neostigmine Anesth. Analg., January 1, 2001; 92(1): 228 - 232. [Abstract] [Full Text] [PDF]

				J.-J. Wang, S.-T. Ho, S.-C. Lee, Y.-C. Liu, and C.-M. Ho The Use of Dexamethasone for Preventing Postoperative Nausea and Vomiting in Females Undergoing Thyroidectomy: A Dose-Ranging Study Anesth. Analg., December 1, 2000; 91(6): 1404 - 1407. [Abstract] [Full Text] [PDF]

				J.-J. Wang, S.-T. Ho, J.-I. Tzeng, and C.-S. Tang The Effect of Timing of Dexamethasone Administration on Its Efficacy as a Prophylactic Antiemetic for Postoperative Nausea and Vomiting Anesth. Analg., July 1, 2000; 91(1): 136 - 139. [Abstract] [Full Text] [PDF]