Low-dose dexamethasone reduces nausea and vomiting after tympanomastoid surgery: A comparison of tropisetron with saline

Abstract

Purpose: The aim of the study was to evaluate the efficacy of low-dose dexamethasone sodium phosphate (5 mg) on the prophylaxis of nausea and vomiting after tympanomastoid surgery. Tropisetron hydrochloride (2 mg) and saline were used as controls. Materials and Methods: One hundred twenty patients (n = 40 in each of 3 groups) undergoing general anesthesia for tympanomastoid surgery were enrolled in this randomized, double-blind, placebo-controlled study. Following endotracheal intubation, group 1 received intravenous dexamethasone 5 mg, whereas groups 2 and 3 received intravenous 2 mg tropisetron and saline, respectively. Several parameters connected with the occurrence of postoperative nausea and vomiting were evaluated. Results: Dexamethasone 5 mg significantly reduced the total incidence of nausea and vomiting by 40% (P =.002). Dexamethasone also reduced the incidence of vomiting episodes by more than 4-fold (P =.03) and the incidence of patients requiring rescue antiemetics (P =.02). Tropisetron at a 2-mg dose did not exhibit any significant antiemetic effect. Conclusions: Dexamethasone sodium phosphate 5 mg was more effective than 2 mg tropisetron hydrochloride and saline in the prevention of nausea and vomiting after tympanomastoid surgery. (Am J Otolaryngol 2002;23:267-271. Copyright 2002, Elsevier Science (USA). All rights reserved.)