We studied the efficacy of a range of doses of
dexamethasone for prevention of
postoperative nausea and vomiting following
strabismus repair in children in a hospital-based, prospective, double-blinded, randomized, placebo-controlled trial. Two hundred and ten children were randomized to receive either
dexamethasone in one of four dosages: 50 microg/kg (Group 1), 100 microg/kg (Group 2), 200 microg/kg (Group 3) and 250 microg/kg (Group 4) or
normal saline (Group 5) prior to corrective surgery for
strabismus. Anaesthesia was standardized and included
nitrous oxide,
pethidine, intubation and the use of muscle relaxant and reversal with
neostigmine.
Postoperative nausea and vomiting were evaluated in epochs of 0-2 hours, 2-6 hours and 6-24 hours after surgery. Parent satisfaction was assessed 24 hours after surgery and the operated eye was examined for
wound infection and delayed healing one week later
Dexamethasone was effective in preventing
nausea and
vomiting after
strabismus repair: 57.1% children in Group 1, 42.9% in Group 2, 52.4% in Group 3, and 59.5% in Group 4 were free from
postoperative nausea and vomiting compared with 7.1% in placebo group. The lowest dose of 50 microg/kg was as efficacious as the higher dosages of
dexamethasone during the 24 hours studied. Of the children who developed
postoperative nausea and vomiting those who received
dexamethasone had significantly fewer episodes than those in the placebo group. We conclude that
dexamethasone 50 microg/kg is effective for the prevention of
postoperative nausea and vomiting following
strabismus repair in children.