Dexamethasone is as effective as ondansetron for the prevention of postoperative nausea and vomiting following breast surgery

Wattwil, Magnus; Thörn, Sven‐Egron; Lövqvist, Åsa; Wattwil, L.; Gupta, Anil; Liljegren, Göran

doi:10.1034/j.1399-6576.2003.00172.x

Cited by 52 publications

(43 citation statements)

References 22 publications

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“…Use of dexamethasone in combination with the other drugs has been reported to increase the antiemetic or analgesic efficacy, and minimal side effects have been reported when it is used as a single agent [13][14][15][16] . The mechanism for the antiemetic effect of dexamethasone has been incompletely understood but it is thought to be caused by the inhibition of prostaglandin synthesis, by showing antiinflammatory efficacy and by causing a decrease in the release of endogenous opiates 17,18 . As an antiemetic agent, it has been used at a dose ranging between 2.5-10 mg/day 19,20 .…”

Section: Introductionmentioning

confidence: 99%

Antiemetic effects of dexamethasone and ondansetron combination during cesarean sections under spinal anaesthesia

Demırhan¹,

Tekelioglu²,

Akkaya³

et al. 2013

Afr H. Sci.

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Background: Nausea and vomiting are frequently seen in patients undergoing cesarean section (CS) under regional anesthesia. We aimed to compare the antiemetic efficacy of ondansetron and dexamethasone combination with that of the use of each agent alone to decrease the incidence of post-delivery intraoperative nausea and vomiting (IONV) during CS under spinal anesthesia. Objective: To compare the antiemetic efficacy of ondansetron and dexamethasone combination with that of the single use of each agent to decrease the incidence of postdelivery IONV during CS under spinal anesthesia. Methods: A randomized, prospective, double blind study was performed on 90 patients undergoing planned CS under spinal anesthesia. Patients received 4mg ondansetron in Group O, 8mg dexamethasone in GroupD, 4mg ondansetron+8mg dexamethasone in Group OD intravenously within 1-2 minutes after the umbilical cord was clamped. Frequency of postdelivery IONV episodes was recorded. Results: A total of 86 eligible patients were included in the study. There were 29 patients in Group O, 29 patients in Group D and 28 patients in Group OD. There were no statistically significant difference between the groups in terms of baseline characteristics and intraoperative managements. Frequency of intraoperative nausea, retching and vomiting experiences were similar between the groups(p>0.05). Conclusion: Single dose 4mg ondansetron, 8mg dexamethasone, or combined use of 8mg dexamethasone+4mg ondansetron, given intravenously is all effective agents for the control of postdelivery IONV. Combined use of dexamethasone and ondansetron for the same indication does not seem to increase the antiemetic efficacy.

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Section: Introductionmentioning

confidence: 99%

Antiemetic effects of dexamethasone and ondansetron combination during cesarean sections under spinal anaesthesia

Demırhan¹,

Tekelioglu²,

Akkaya³

et al. 2013

Afr H. Sci.

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“…It has previously been found that ondansetron 4 mg and dexamethasone 4 mg are equally effective in the prevention of PONV following breast surgery [6]. The incidence of PONV was similar between the groups and was reduced to around 35%.…”

Section: Introductionmentioning

confidence: 74%

Betamethasone in prevention of postoperative nausea and vomiting following breast surgery

Olanders

Lundgren

Johansson

2014

Journal of Clinical Anesthesia

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“…Our work suggests that betamethasone does not have dopamine-antagonistic effects. [1][2][3] Mainly dexamethasone and, to a lesser extent, betamethasone have been used. 3,4 The rank order of antiemetic activity of the glucocorticoids is remarkably similar to their known rank order of anti-inflammatory potency, where dexamethasone and betamethasone are approximately equipotent but more potent than methylprednisolone and hydrocortisone respectively.…”

Section: Discussionmentioning

confidence: 99%

Betamethasone does not prevent nausea and vomiting induced by the dopamine-agonist apomorphine

Axelsson

Thörn

Lövqvist

et al. 2006

Can J Anesth/J Can Anesth

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Purpose:The mechanism of the antiemetic actions of corticosteroids is not known. The purpose of this study was to evaluate if betamethasone can prevent nausea, vomiting or increase of vasopressin induced by apomorphine. Metoclopramide, a dopamine antagonist, was used as a control substance. Methods:Ten healthy volunteers were studied on three occasions. In a randomized order they were allocated to receive pretreatment with betamethasone 8 mg iv, metoclopramide 10 mg iv, and normal saline 2 mL as placebo on the three different occasions, 15 min before the administration of apomorphine 30 µg·kg -1 sc. After administration of apomorphine, episodes of vomiting were recorded, and the intensity of nausea was estimated by the subject on a visual analogue scale (VAS 0-10 cm). Blood samples for analysis of plasma concentrations of vasopressin were analyzed. Results:One volunteer decided to withdraw, as he experienced akathisia after receiving metoclopramide. During the first two hours after apomorphine, eight of nine volunteers vomited both after betamethasone and placebo. One volunteer did not vomit after betamethasone and placebo but he experienced nausea. None of the volunteers vomited after metoclopramide (P < 0.01 vs betamethasone and placebo). The maximum VAS for nausea was significantly higher after betamethasone and placebo compared to metoclopramide (P < 0.01). The vasopressin levels increased after betamethasone and placebo, but there was no increase in any volunteer after pretreatment with metoclopramide. Conclusion:This study demonstrates that betamethasone does not prevent nausea, vomiting and increase of vasopressin induced by apomorphine, whereas metoclopramide prevents apomorphine-induced emesis. Our work suggests that betamethasone does not have dopamine-antagonistic effects. Objectif

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Dexamethasone is as effective as ondansetron for the prevention of postoperative nausea and vomiting following breast surgery

Cited by 52 publications

References 22 publications

Antiemetic effects of dexamethasone and ondansetron combination during cesarean sections under spinal anaesthesia

Antiemetic effects of dexamethasone and ondansetron combination during cesarean sections under spinal anaesthesia

Betamethasone in prevention of postoperative nausea and vomiting following breast surgery

Betamethasone does not prevent nausea and vomiting induced by the dopamine-agonist apomorphine

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