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Influence of dexamethasone on nausea and vomiting during patient-controlled analgesia with tramadol



Influence of dexamethasone on nausea and vomiting during patient-controlled analgesia with tramadol



Clinical Drug Investigation 22(8): 547-552



Objective: The aim of this study was to evaluate the prophylactic effect of dexamethasone on postoperative nausea and vomiting (PONV) during patient-controlled analgesia (PCA) with tramadol. Methods: 50 patients (American Society of Anesthesiologists (ASA) I-II) were enrolled in this randomised, placebo-controlled study. In group I, saline was administered as a control. In group II, 150 mug/kg dexamethasone was administered as an intravenous bolus and then tramadol added in the PCA device. We assessed PONV and the need for rescue antiemetics in the 24 hours postoperatively. Results: 17 of 25 dexamethasone-treated patients (68%) had no nausea, four patients (16%) experienced nausea, two patients (8%) retched, two patients (8%) vomited once, no patients vomited repeatedly and seven patients (28%) required rescue antiemetics. In the placebo-treated group, three of 25 patients (12%) had no nausea, 12 (48%) had nausea, three (12%) retched, three patients (12%) vomited once, four patients (16%) vomited repeatedly and 17 patients (68%) required a rescue antiemetic. The incidence of nausea, vomiting and administration of a rescue antiemetic were significantly less in dexamethasone recipients compared with the saline-treated group (p<0.05). There were no significant differences between the groups in the pain score results or in the consumption of tramadol. Conclusion: Our results demonstrate that a single dose of dexamethasone reduced the incidence of PONV during PCA with tramadol.

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Accession: 010838345

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DOI: 10.2165/00044011-200222080-00007


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