We searched Pubmed, Embase, and Cochrane Library databases for randomized controlled trials (RCTs) that evaluated the prophylactic effect of
dexamethasone versus placebo with or without other
antiemetics for
PONV in patients undergoing
thyroidectomy. Meta-analyses were performed using RevMan 5.0 software.
RESULTS: Thirteen RCTs that considered high quality evidence including 2,180 patients were analyzed. The meta-analysis demonstrated a significant decrease in the incidence of
PONV (RR 0.52, 95% CI 0.43 to 0.63, P < 0.00001), the need for rescue
anti-emetics (RR 0.42, 95% CI 0.30 to 0.57, P<0.00001),
post-operative pain scores (WMD -1.17, 95% CI -1.91 to -0.44, P = 0.002), and the need for rescue
analgesics (RR 0.65, 95% CI 0.50-0.83, P = 0.0008) in patients receiving
dexamethasone compared to placebo, with or without concomitant
antiemetics.
Dexamethasone 8-10mg had a significantly greater effect for reducing the incidence of
PONV than
dexamethasone 1.25-5mg.
Dexamethasone was as effective as other
anti-emetics for reducing
PONV (RR 1.25, 95% CI 0.86-1.81, P = 0.24). A significantly higher level of
blood glucose during the immediate post-operative period in patients receiving
dexamethasone compared to controls was the only adverse event.
CONCLUSIONS: