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GENERAL ARTICLES

Small-Dose Dexamethasone Reduces Nausea and Vomiting After Laparoscopic Cholecystectomy: A Comparison of Tropisetron with Saline

Jhi-Joung Wang, MD, DMS^*, Shung-Tai Ho, MD, MS, Yih-Huei Uen, MD, Mao-Tsun Lin, PhD^*, Kuan-Ting Chen, MD^*, Jeng-Chai Huang, PhD^*, and Jann-Inn Tzeng, MD^*

Departments of *Anesthesiology and Surgery, Chi-Mei Medical Center, Tainan, Taiwan; and Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

Address correspondence and reprint requests to Jhi-Joung Wang, MD, DMS, Department of Anesthesiology, Chi-Mei Medical Center, Tainan, Taiwan. Address e-mail to 400002{at}mail.chimei.org.tw

Dexamethasone is an effective antiemetic drug, but the efficacy of small-dose dexamethasone 5 mg on the prophylaxis of postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic chole-cystectomy has not been evaluated. We, therefore, evaluated the prophylactic effect of small-dose dexamethasone (5 mg) on PONV in patients undergoing laparoscopic cholecystectomy. Tropisetron and saline served as controls. One-hundred-twenty patients scheduled for laparoscopic cholecystectomy were enrolled in a randomized, double-blinded, placebo-controlled study. At the induction of anesthesia, the Dexamethasone group received IV dexamethasone 5 mg, the Tropisetron group received IV tropisetron 2 mg, and the Pla- cebo group received IV saline. We found that both dexamethasone and tropisetron significantly decreased the following variables: the total incidence of PONV (P < 0.01), more than four vomiting episodes (P < 0.05), and the proportions of patients requiring rescue antiemetics (P < 0.05). The differences between the Dexamethasone and Tropisetron groups were not significant. We conclude that prophylactic IV dexamethasone 5 mg significantly reduces the incidence of PONV in patients undergoing laparoscopic cholecystectomy. At this dose, dexamethasone is as effective as tropisetron 2 mg and is more effective than placebo.

IMPLICATIONS: We evaluated the prophylactic effect of small-dose dexamethasone (5 mg) on postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy. Tropisetron (2 mg) and saline served as controls. We found that dexamethasone 5 mg (IV) significantly reduced the incidence of PONV in these patients, and, at this dose, dexamethasone was as effective as tropisetron and was more effective than placebo.

This article has been cited by other articles:

				A. L Kovac Meta-Analysis of the Use of Rescue Antiemetics Following PONV Prophylactic Failure with 5-HT3 Antagonist/Dexamethasone Versus Single-Agent Therapies Ann. Pharmacother., May 1, 2006; 40(5): 873 - 887. [Abstract] [Full Text] [PDF]

				A. Goldfaden and J. D. Birkmeyer Evidence-Based Practice in Laparoscopic Surgery: Perioperative Care Surgical Innovation, March 1, 2005; 12(1): 51 - 61. [Abstract] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999