Key result
Preoperative dexamethasone reduces moderate-to-severe PONV ~89% vs. saline in thyroidectomy.
Why the study?
Postoperative nausea and vomiting, severe pain with local inflammation, and voice impairment are common after thyroidectomy and may be influenced by steroid use.
Does a single preoperative dose of dexamethasone reduce postoperative nausea, vomiting, and pain in patients undergoing thyroidectomy?
RCT (n=72)
No
Does a single preoperative dose of dexamethasone reduce postoperative nausea, vomiting, and pain in patients undergoing thyroidectomy?
Absolute Event Rate: 11.4% vs 100%
p-value: p=0.001
A single preoperative dose of dexamethasone significantly reduces postoperative nausea and vomiting in patients undergoing thyroidectomy.
May support dexamethasone for PONV prevention in thyroidectomy; hypothesis-generating and requires RCTs before practice change.
Background: On thyroidectomy, incidence of postoperative nausea and vomiting, severe pain with local inflammation and voice impairment was very common. These effects can be manipulated by the use of steroids. Hence the present study, was conducted with the objective to evaluate the effects of a single preoperative dose of dexamethasone on thyroidectomy in terms of postoperative nausea and vomiting (PONV), pain and voice improvement.Methods: The present study was conducted between October 2010 and March 2011 at the Department of General Surgery, Government Medical College, Kottayam, Kerala, India. A total of 72 patients were included in the study after meeting requirements of inclusion criteria. They were divided into two groups. 37 were under Group C and received normal saline and remaining 35 served as Group D and received 8 mg/2 mL of dexamethasone preoperatively. Post-operative incidences of nausea and vomiting, pain scores, and the improvement of vocal function were compared in both groups.Results: Out of 72 patients, most of the patients participated were under the age group of 40-50 years (30.6%). Of them 9 were males and 63 were females. The incidence and severity of PONV and pain was significantly reduced in Group D compared to Group C with P values of 0.001 and 0.056 respectively. Significant protection of dexamethasone towards vocal function was not observed in the study (p =0.245).Conclusions: From the results obtained in the study, it was concluded that preoperative single dose administration of dexamethasone seemed to be safe in healthy patients undergoing thyroidectomy.
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Gamalial et al. (2017) conducted an RCT in Benign thyroid disease requiring thyroidectomy (n=72). Dexamethasone vs. Normal saline was evaluated on Incidence and severity of postoperative nausea and vomiting (PONV) (p=0.001). A single preoperative dose of 8 mg dexamethasone significantly reduced the incidence of moderate-to-severe postoperative nausea and vomiting compared to normal saline (11.4% vs 100.0%, p=0.001) in patients undergoing thyroidectomy.
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