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Prophylactic dexamethasone for postoperative nausea and vomiting in pediatric strabismus surgery: a dose ranging and safety evaluation study.

Abstract
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.
AuthorsRashmi Madan, Anuj Bhatia, Sajith Chakithandy, Rajeshwari Subramaniam, Gurram Rammohan, Shrinivas Deshpande, Manorama Singh, H L Kaul
JournalAnesthesia and analgesia (Anesth Analg) Vol. 100 Issue 6 Pg. 1622-1626 (Jun 2005) ISSN: 0003-2999 [Print] United States
PMID15920184 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
Chemical References
  • Antiemetics
  • Blood Glucose
  • Dexamethasone
  • Metoclopramide
Topics
  • Adolescent
  • Aging (physiology)
  • Anesthesia, General
  • Antiemetics (administration & dosage, adverse effects, therapeutic use)
  • Blood Glucose (metabolism)
  • Child
  • Child, Preschool
  • Dexamethasone (administration & dosage, adverse effects, therapeutic use)
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Metoclopramide (therapeutic use)
  • Postoperative Nausea and Vomiting (prevention & control)
  • Strabismus (surgery)
  • Treatment Outcome

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