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REGIONAL ANESTHESIA AND PAIN MEDICINE

The Effect of Dexamethasone on Postoperative Pain and Emesis After Intrathecal Neostigmine

Ping-Heng Tan, MD^*, Kang Liu, MD, Chih-Hsien Peng, MD, Ling-Cheng Yang, MD^*, Chung-Ren Lin, MD^*, and Cheng-Yuan Lu, MD^*

*Department of Anesthesia, Chang Gung Memorial Hospital, Kaohsiung; Department of Anesthesia, Veterans General Hospital, Kaohsiung, National Yang-Ming University School of Medicine; and Department of Anesthesia, Feng-Yuan Hospital, Taichung, Taiwan, ROC

Address correspondence and reprint requests to Dr. Ping-Heng Tan, No. 2, LN183, Zong-Jong Rd., Kaohsiung 813, Taiwan, ROC. Address e-mail to tanph{at}gcn.net.tw

We evaluated the effect of a single dose of dexamethasone on the incidence and severity of postoperative nausea and vomiting (PONV) after intrathecal injection of tetracaine plus neostigmine. Sixty ASA physical status I patients scheduled for inguinal herniorrhaphy were studied with a randomized, double-blinded, placebo-controlled protocol. The dexamethasone group (Group D) received 10 mg of dexamethasone IV before performance of spinal anesthesia, whereas the placebo group (Group P) received saline. Spinal anesthesia was performed with intrathecal injection of 15 mg tetracaine plus neostigmine 100 µg in both groups. Pain, PONV, and other side effects were evaluated 24 h after surgery. The duration and severity of analgesia and the incidence of PONV were not significantly different between the two groups. Our results demonstrate that a single dose of dexamethasone (10 mg) did not potentiate the analgesic effect or reduce the incidence of PONV after intrathecal injection of tetracaine and neostigmine.

Implications: The results of our evaluation of the effect of IV dexamethasone versus saline control on analgesia and nausea and vomiting after intrathecal neostigmine and tetracaine suggest that IV dexamethasone did not enhance the analgesic effect of neostigmine or reduce the incidence of emesis after intrathecal administration.

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