Betamethasone in prevention of postoperative nausea and vomiting following breast surgery

Abstract

Study objective: To investigate whether betamethasone decreases the incidence of postoperative nausea/vomiting (PONV) and reduces postoperative pain following partial mastectomy.

Design: Prospective randomized, double-blinded study.

Setting: Operating room and Postanesthesia Care Unit of a university hospital.

Patients: 80 ASA physical status 1 and 2 women scheduled for elective breast cancer surgery.

Interventions: Patients were randomly allocated to two groups in double-blinded fashion: Group B (betamethasone; 37 pts) and Group C (control; 38 pts). Group B received 8 mg of betamethasone intravenously before the start of surgery.

Measurements: The rate of PONV and pain were recorded using a numeric rating scale (NRS; 0-10), as well as rescue doses of antiemetics (ondansetron) and analgesics (ketobemidone).

Main results: There was a significant lower incidence of postoperative nausea (PON) scoring NRS ≥ 1 in Group B in the 4 to 12-hour period compared with Group C (P = 0.02). The cumulative incidence of PON was 57% in Group B versus 68% in Group C (P = 0.27). The overall incidence of postoperative vomiting (POV) was 18% and 20% in Groups B and C, respectively. Postoperative pain was reduced by 40% in Group B in the 4 to 12-hour period, but the mean dose of postoperative rescue analgesic did not differ between the groups.

Conclusions: Preoperative betamethasone reduces the severity of PONV and pain in patients undergoing elective breast surgery.

Keywords: Betamethasone; Breast surgery; Postoperative nausea and vomiting.