Key result
A single intravenous dose of dexamethasone significantly reduced the incidence of postoperative vomiting (21.6% vs 32.4%, p=0.012) and postoperative pain scores compared to placebo in patients undergoing breast surgery.
Why the study?
The study was conducted to assess the efficacy of intravenous dexamethasone in preventing postoperative nausea and vomiting in patients undergoing breast surgery under general anesthesia.
Does a single dose of intravenous dexamethasone reduce postoperative nausea, vomiting, and pain in patients undergoing breast surgery under general anesthesia?
RCT (n=74)
Placebo-controlled
Balloting without replacement
No
Does a single dose of intravenous dexamethasone reduce postoperative nausea, vomiting, and pain in patients undergoing breast surgery under general anesthesia?
Absolute Event Rate: 21.6% vs 32.4%
p-value: p=0.012
A single dose of intravenous dexamethasone significantly reduces postoperative pain and the incidence of nausea and vomiting in patients undergoing breast surgery under general anesthesia.
Supports single-dose IV dexamethasone to minimize PONV and pain after breast surgery; extends evidence from other procedures to this population.
Objective: The primary purpose of this study is to assess the efficacy of intravenous dexamethasone in preventing postoperative nausea and vomiting in patients who have had breast surgery under general anesthesia. Methods: After ethical approval from institution review board, this randomized control was carried out at Liaqat national hospital and medical college. Seventy-four patients who completed the study's criteria and provided written informed permission were enrolled in a random order. Patients were recruited and then randomly assigned through balloting without replacement to one of two groups: (A) dexamethasone (n = 37) or (B) placebo (n = 37). After general anesthesia, patients in Group received 0.1mg/kg of dexamethasone intravenously at the same time. Patients in Group B received a placebo (2 ml of normal saline 0.9% at the same time following general anesthesia). Mean arterial blood pressure (MAP), heart rate (HR), respiration rate (RR), and the intensity of pain and vomiting was measured at 0 (in the operating room), 30, 60, and 120 minutes, and 4-, 6-, 12-, and 24-hours following surgery. Results: The mean age of the participants in both study groups were 48.56±15.25 and 50.4±16.8 years. The mean anesthesia time of the participants in both study groups were 114±9.6 and 122.7±8.7 minutes. The mean surgery time of the participants in both study groups were 88.2±2.1 and 96.1±3.72 minutes. No significant difference in the heart rate (HR) was observed in both study groups at any time interval. A significant difference in the heart rate was observed in both study groups at 6-, 12-, and 24-hours’ time interval. A significant difference in the heart rate was observed in both study groups at 0 and 30 minutes, 1-,2-,4-, 6-, 12-, and 24-hours’ time interval. Conclusion: There were no notable changes in vital signs associated with the use of intravenous dexamethasone for the treatment of postoperative pain, the need for rescue analgesia on postoperative day 1, or the occurrence of postoperative nausea and vomiting.
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Khalid et al. (2023) conducted an RCT in Breast surgery under general anesthesia (n=74). Dexamethasone vs. Placebo (2 ml of normal saline 0.9%) was evaluated on Incidence of postoperative vomiting (p=0.012). A single intravenous dose of dexamethasone significantly reduced the incidence of postoperative vomiting (21.6% vs 32.4%, p=0.012) and postoperative pain scores compared to placebo in patients undergoing breast surgery.
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