In this double-blind, randomized, placebo-controlled study, we evaluated the efficacy and safety of different doses of prophylactic IV
dexamethasone for
postoperative nausea and vomiting (
PONV) in 168 children (aged 2-15 yr) scheduled for
strabismus surgery. Patients received IV
dexamethasone 0.25 mg/kg (D 0.25), 0.5 mg/kg (D 0.5), 1.0 mg/kg (D 1), or saline (S) immediately after induction of
general anesthesia. Patients were discharged 24 h after surgery.
Nausea and
vomiting were assessed at 0-2, 2-6, and 6-24 h after surgery.
Blood glucose was measured preoperatively and at 4 h after study
drug administration. Wound healing and
infection were assessed after 1 wk. More patients in group S had
vomiting at 0-2, 2-6, and 6-24 h (P = 0.001, P = 0.003, and P = 0.04, respectively) and required larger doses of rescue
antiemetics compared with the
dexamethasone groups. Fewer patients in the
dexamethasone groups (6, 3, and 6 in D 0.25, D 0.5, and D 1, respectively) had severe
PONV compared with group S (P = 0.001). No significant increase in postoperative
blood glucose levels was observed and wound healing was satisfactory in all four groups. The results suggest that
dexamethasone 0.25 mg/kg is more effective than saline and equally effective compared with larger doses for preventing
PONV for pediatric
strabismus surgery.