Single-dose dexamethasone administered preoperatively reduces nausea and vomiting following middle ear surgery

Abdelkhalek Aboulseoud, Noha Sayed Hussien
Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Ain-Shams University, Cairo, Egypt

Correspondence Address:
Noha Sayed Hussien
MD, Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Ain Shams University, 11566 Cairo
Egypt

Source of Support: None, Conflict of Interest: None

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DOI: 10.7123/01.ASJA.0000417550.89826.75

The objective of this study was to evaluate the efficacy of a preoperative single-dose of dexamethasone (8 mg) in ameliorating postoperative nausea and vomiting (PONV) after middle ear surgery.

Forty patients scheduled for middle ear surgeries were enrolled in this prospective, double-blind, placebo-controlled study. They were randomly divided into two groups. Group A, which was the test group (patients were intravenously administered 2 ml of 8 mg dexamethasone 1 h preoperatively), and group B, which was the placebo group (patients were intravenously administered 2 ml of normal saline 1 h preoperatively). All patients underwent standard GA and tympanoplasty conducted by the same anaesthetic and surgical teams. Number of episodes of PONV were recorded from onset of recovery in the post-operative care unit (PACU) until 24 h postoperatively. Antiemetic requirements and vital data were recorded for 24 h postoperatively.

There were significant statistical differences between the two groups during the early postoperative period in the PACU and at 2 and 4–6 h postoperatively, with the results being in favour of group A. In the PACU no patient in group A experienced nausea or vomiting as compared with two patients (10%) in group B who experienced nausea and one patient (5%) who experienced vomiting (P=0.001 and 0.01, respectively). At 2 h postoperatively, one patient (5%) in group A experienced nausea and no patient suffered from vomiting compared with three patients (15%) in group B who had nausea and two patients (10%) who experienced vomiting (P=0.001). At 4–6 h postoperatively, one patient (5%) in group A suffered from nausea and one patient (5%) experienced vomiting, whereas two patients (10%) in group B had nausea and two patients (10%) experienced vomiting (P=0.01). At 12 h postoperatively, one patient (5%) in both groups experienced nausea and no patient experienced vomiting (P=0.224). At 24 h postoperatively there were no patients suffering from nausea or vomiting in either group. In group A the total number of episodes of nausea and vomiting were three (15%) and one (5%), respectively, as compared with eight incidences (40%) of nausea and five incidences (25%) of vomiting in group B (P=0.001). The mean dose of ondansetron (Zofran) used as an antiemetic supplement was 4.6±1.1 mg in group A and 8.0±3 mg in group B (P=0.01).

Preoperative intravenous administration of single-dose dexamethasone (8 mg) can significantly reduce the incidence of PONV in patients undergoing middle ear surgeries and can therefore be considered a reliable prophylactic antiemetic drug.