Preoperative dexamethasone reduces postoperative pain, nausea and vomiting following mastectomy for breast cancer

Abstract

BackgroundDexamethasone has been reported to reduce postoperative symptoms after different surgical procedures. We evaluated the efficacy of preoperative dexamethasone in ameliorating postoperative nausea and vomiting (PONV), and pain after mastectomy.MethodsIn this prospective, double-blind, placebo-controlled study, 70 patients scheduled for mastectomy with axillary lymph node dissection were analyzed after randomization to treatment with 8 mg intravenous dexamethasone (n = 35) or placebo (n = 35). All patients underwent standardized procedures for general anesthesia and surgery. Episodes of PONV and pain score were recorded on a visual analogue scale. Analgesic and antiemetic requirements were also recorded.ResultsDemographic and medical variables were similar between groups. The incidence of PONV was lower in the dexamethasone group at the early postoperative evaluation (28.6% vs. 60%; p = 0.02) and at 6 h (17.2% vs. 45.8%; p = 0.03). More patients in the placebo group required additional antiemetic medication (21 vs. 8; p = 0.01). Dexamethasone treatment significantly reduced postoperative pain just after surgery (VAS score, 4.54 ± 1.55 vs. 5.83 ± 2.00; p = 0.004), at 6 h (3.03 ± 1.20 vs. 4.17 ± 1.24; p < 0.0005) and at 12 h (2.09 ± 0.85 vs. 2.54 ± 0.98; p = 0.04). Analgesics were required in more patients of the control group (21 vs. 10; p = 0.008). There were no adverse events, morbidity or mortality.ConclusionsPreoperative intravenous dexamethasone (8 mg) can significantly reduce the incidence of PONV and pain in patients undergoing mastectomy with axillary dissection for breast cancer.Trial registration numberNCT01116713

The Prophylactic Effect of Timing of Dexamethasone on Postoperative Nausea and Vomiting in Patients Undergoing General Anaesthesia – A Randomised Double Blinded Placebo Controlled Study

“…There was no statistical difference between Group 2 and group 3. These findings were very much similar to the study done by Murphy et al (21) , Gomez et al (22) and Wu et al (23) Murphy et al studied the use of pre operative dexamethasone in patients undergoing cholecystectomy surgeries. Gomez et al studied the use of pre operative dexamethasone in patients undergoing mastectomy and Wu et al studied the prophylactic effect of dexamethasone in patients undergoing anorectal surgeries.…”

Effect of nefopam- versus fentanyl-based patient-controlled analgesia on postoperative nausea and vomiting in patients undergoing gynecological laparoscopic surgery: a prospective double-blind randomized controlled trial

“…PONV was assessed using a four-point ordinal scale 14 upon arrival at the PACU (PACU arrival); at 30 min after PACU arrival (30 min); and at 24 h (24 h), 48 h (48 h), and 72 h after PACU discharge (72 h). Nausea was defined as a subjectively unpleasant sensation associated with awareness of the urge to vomit.…”

A Comparative Study of Ondansetron versus Ondansetron with Dexamethasone in Prevention of Postoperative Nausea and Vomiting (PONV) in Patients Undergoing Modified Radical Mastectomy with Axillary Node Dissection Under General Anaesthesia

“…The primary efficacy outcome in this study was defined as a complete response to antiemetic prophylaxis. 9 This in turn was defined as no vomiting, no moderate nausea sustained for 15 min or more and no application for administration of rescue antiemetic medication. Rescue analgesic consisted of 75 mg. diclofenac sodium infusion.…”