A prospective, randomized, double-blind, placebo-controlled study was undertaken to evaluate the efficacy of
dexamethasone for reducing
postoperative nausea and vomiting (
PONV) and
analgesic requirements after middle ear surgery. Adult Japanese patients were allocated randomly to 1 of 3 groups (
n = 30 each) to receive either placebo or
dexamethasone at 2 different doses (4 mg and 8 mg) immediately before induction of
anesthesia. Postoperatively,
emetic episodes and
analgesic requirements were evaluated by a blinded investigator. The rate of patients experiencing
PONV during the first 24 h after
anesthesia was 30% with
dexamethasone 4 mg (P = 0.005) and 23% with
dexamethasone 8 mg (P = 0.001) compared with 67% with placebo. The need for
indomethacin for postoperative intolerable
pain control was less in patients who had received
dexamethasone 8 mg than in those who had received placebo (P = 0.018). No difference in
analgesic requirement was found between the
dexamethasone 4 mg and placebo groups (P = 0.396). No clinically important adverse events attributable to the study drug were observed in any of the groups. In conclusion,
dexamethasone 8 mg is effective in reducing the rate of
PONV and
analgesic requirements in adult Japanese patients undergoing middle ear surgery.