The Effect of Dexamethasone on Postoperative Vomiting After Tonsillectomy

Aouad, Marie T.; Siddik, Sahar; Rizk, Laudia B.; Zaytoun, Georges; Baraka, Anis

doi:10.1097/00000539-200103000-00015

Cited by 63 publications

(73 citation statements)

References 25 publications

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“…14 Complete antiemetic response was reported to be 60% with dexamethasone 0.15 mg·kg -1 (maximum dose, 8 mg), 16 76% with dexamethasone 1 mg·kg -1 (maximum dose, 25 mg), 15 77% with dexamethasone 0.5 mg·kg -1 (maximum dose, 8 mg) 14 and 80% with our regimen. There was a remarkably low incidence of postoperative vomiting of 5%, with the combination of dexamethasone plus a low dose of ondansetron after strabismus surgery in children when compared with dexamethasone alone.…”

Section: Figure 1 Median Children's Hospital Eastern Ontario Painmentioning

confidence: 62%

Dexamethasone reduces postoperative vomiting and pain after pediatric tonsillectomy

Elhakim

Rashed

et al. 2003

Can J Anesth/J Can Anesth

148

121

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P Pu ur rp po os se e: : Previous studies on dexamethasone's antiemetic and analgesic potential in children undergoing tonsillectomy have produced conflicting results. The aim of this study was to evaluate the effects of a single dose of dexamethasone on the incidence and severity of postoperative vomiting and pain in children undergoing electrocautery tonsillectomy under standardized general anesthesia. M Me et th ho od ds s: :In a double-blinded study, 120 patients were randomly allocated to receive either dexamethasone 0.5 mg·kg -1 (maximum dose 8 mg) iv or an equivalent volume of saline preoperatively. The incidence of early and late vomiting, need for rescue antiemetics, time to first oral intake, time to first demand of analgesia and analgesic consumption were compared in both groups. Pain scores used included Children's Hospital Eastern Ontario Pain Scale, "faces", and a 0-10 visual analogue pain scale.R Re es su ul lt ts s: : Compared with placebo, dexamethasone significantly decreased the incidence of early and late vomiting (P < 0.05, P < 0.001 respectively). Fewer patients in the dexamethasone group needed antiemetic rescue (P < 0.01). The time to first oral intake was shorter, and the time to first dose of analgesic was longer in the dexamethasone group (P < 0.01). Pain scores 30 min after extubation were lower (P < 0.05) in the dexamethasone group. At 12 and 24 hr postoperative swallowing was still significantly less painful in the dexamethasone group than in the control group (P < 0.01).C Co on nc cl lu us si io on n: : Preoperative dexamethasone 0.5 mg·kg -1 iv reduced both postoperative vomiting and pain in children after electrocautery tonsillectomy. ONSILLECTOMY is one of the most frequently performed ambulatory surgical procedures in children and is associated with an incidence of postoperative vomiting ranging between 40% and 73%. 1-3 The introduction of an electrodissection surgical technique has virtually eliminated immediate postoperative hemorrhage. However, it may cause more pain, discomfort Résultats : Comparée au placebo, la dexaméthasone a significativement réduit l'incidence de vomissements précoces et tardifs (P < 0,05, P < 0,001 respectivement). Peu de patients ayant reçu la dexaméthasone ont eu besoin d'antiémétique de secours (P < 0,01

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Section: Figure 1 Median Children's Hospital Eastern Ontario Painmentioning

confidence: 62%

Dexamethasone reduces postoperative vomiting and pain after pediatric tonsillectomy

Elhakim

Rashed

et al. 2003

Can J Anesth/J Can Anesth

148

121

View full text Add to dashboard Cite

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“…IV dexamethasone 4 mg was selected as the routine antiemetic prophylaxis. It has been found to be a costeffective prophylactic antiemetic, with a number needed to treat of 4.7 for PONV (26)(27)(28). Despite this antiemetic prophylaxis, the overall incidence of PONV in our sham group was reported at 64.9%.…”

Section: Discussionmentioning

confidence: 80%

Effectiveness of P6 acupoint electrical stimulation in preventing postoperativenausea and vomiting following laparoscopic surgery

Yeoh¹,

Tang²,

Manap³

et al. 2016

Turk J Med Sci

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Background/aim: The effects of pericardium 6 (P6) electrical stimulation in patients at risk of postoperative nausea and vomiting (PONV) following laparoscopic surgery were evaluated. Materials and methods:Eighty patients for laparoscopic surgery with at least one of the determined risks (nonsmoker, female, previous PONV/motion sickness, or postoperative opioid use) were randomized into either an active or sham group. At the end of surgery, Reletex electrical acustimulation was placed at the P6 acupoint. The active group had grade 3 strength and the sham group had inactivated electrodes covered by silicone. It was worn for 24 h following surgery. PONV scores were recorded. Results:The active group had significantly shorter durations of surgery and lower PONV incidence over 24 h (35.1% versus 64.9%, P = 0.024) and this was attributed to the lower incidence of nausea (31.4% versus 68.6%, P = 0.006). The overall incidence of vomiting was not significantly different between the groups, but it was higher in the sham group of patients with PONV risk score 3 (23.9%, P = 0.049). Conclusion:In patients at high risk for PONV, P6 acupoint electrical stimulation lowers the PONV incidence by reducing the nausea component. However, this reduction in nausea is not related to increasing PONV risk scores.

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“…Previous studies investigating the effect of intravenously administered DX on nausea and vomiting following tonsillectomy have found promising results 2,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] In these studies, DX was most commonly administered as a single intravenous dose before tonsil dissection. In these studies, administered doses were 4 32 or 50 mg 17 was injected with the additional goal of reducing post-tonsillectomy pain 6, 7, 9, 10, 12, 14-17, 19, 20, 22, 24, 25, 35-38 .…”

Section: Discussionmentioning

confidence: 99%

The effect of dexamethasone on post-tonsillectomy nausea, vomiting and bleeding

Windfuhr¹,

Chen²,

Propst³

et al. 2011

Braz. j. otorhinolaryngol. (Impr.)

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It has been stated, that the administration of Dexamethasone has an impact on the morbidity following tonsillectomy.Objective: To re-calculate the blood values for Dexamethasone when given as fixed doses and to evaluate the effect of Dexamethasone on post-operative nausea, vomiting and bleeding rates following tonsillectomy. Materials and methods:The charts of 272 children (2-15 years) who had undergone tonsillectomy were analyzed. The rates of post-operative nausea, vomiting and bleeding in relation to Dexamethasone were calculated-in general and different doses (0 mg/kg, <0.15 mg/kg, >0.15 mg/kg). Study design:Retrospective cohort study.Results: Dexamethasone was administered in 121 children (43.7%) according to the preference of the anesthesist (mean dose: 0.2 +/-0.12 mg/kg; range: 0.04 -0.62 mg/kg). There was no significant difference in nausea and vomiting (p=0.953) or bleeding (p=0.827) across groups receiving or not receiving Dexamethasone. Stratification into three different groups of Dexamethasone concentration also did not identify a dose-related risk of postoperative nausea or vomiting (p=0.98) or bleeding (p=0.71). Conclusion:At least under common non-controlled conditions in the clinic, Dexamethasone does not appear to have an effect on nausea or vomiting or bleeding following tonsillectomy. Braz J Otorhinolaryngol. 2011;77(3):373-9. ORIGINAL ARTICLE BJORL

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The Effect of Dexamethasone on Postoperative Vomiting After Tonsillectomy

Cited by 63 publications

References 25 publications

Dexamethasone reduces postoperative vomiting and pain after pediatric tonsillectomy

Dexamethasone reduces postoperative vomiting and pain after pediatric tonsillectomy

Effectiveness of P6 acupoint electrical stimulation in preventing postoperativenausea and vomiting following laparoscopic surgery

The effect of dexamethasone on post-tonsillectomy nausea, vomiting and bleeding

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