Prevention of postoperative nausea and vomiting with a small dose of propofol combined with dexamethasone 4 mg or dexamethasone 8 mg in patients undergoing middle ear surgery: a prospective, randomized, double-blind study
- PMID: 21692408
Prevention of postoperative nausea and vomiting with a small dose of propofol combined with dexamethasone 4 mg or dexamethasone 8 mg in patients undergoing middle ear surgery: a prospective, randomized, double-blind study
Abstract
Objective: Postoperative nausea and vomiting (PONV) is a common complication after middle ear surgery. We have aimed to compare the administration of a subhypnotic dose of propofol with dexamethasone 4 mg or 8 mg and placebo in prevention of postoperative nausea and vomiting (PONV) after middle ear surgery.
Method: This clinical research was performed at Yüksek Ihtisas Hospital Kirikkale. The study included 105 adult patients scheduled for a middle ear operation. The patients were randomly assigned into three groups. The patients in Group I received propofol in a dose of 0.5 mg x kg(-1) plus 4 mg of dexamethasone while Group II was administered with propofol in a dose of 0.5 mg x kg(-1) plus 8 mg of dexamethasone, and Group III was given 0.9% saline solution. Within the framework of the study we evaluated the number of patients suffering from nausea and vomiting at 0-4, 4-12, and 12-24 hours postoperatively, and the necessity to use additional antiemetics.
Results: The comparison of data showed that at up to four hours, the incidence of vomiting was 28.6% in Group 1, 22.9% in Group II, and 65.7% in Group III. The incidence rates in Group I and Group II were significantly lower than that in Group III (p < 0.05), while the rate of antiemetic drug usage was higher in Group III than in Group I and Group II (p < 0.05). The Nausea Vomiting Scale scores were also significantly higher in Group III than in Group I and Group II (p < 0.05). There were no significant differences between the values at 4-12 and 12-24 hours.
Conclusion: The administration of a subhypnotic dose of propofol plus 4 mg of dexamethasone at the end of surgery was found to be at least as effective as propofol plus 8 mg of dexamethasone in preventing the PONV in the early postoperative period in adult patients undergoing middle ear surgery (Tab. 4, Ref. 34).