Dexamethasone 8 mg Versus Dexamethasone 4 mg with Propofol 0.5 mg/kg for the Prevention of Postoperative Nausea and Vomiting after Laparoscopic Gynaecology Procedure

摘要

Background and Aims: This was a prospective randomized double blind study to compare dexamethasone 8 mg with dexamethasone 4 mg plus subhypnotic dose of propofol 0.5 mg/kg as prophylaxis against post operative nausea and vomiting (PONV) in patients undergoing laparoscopic gynaecology procedures. Methods: One hundred ASA physical status Class I and II patients scheduled for elective laparoscopic gynaecological procedures under general anaesthesia were randomized into two groups: Group A received 8 mg dexamethasone plus 0.05 ml/kg of normal saline while Group B received 4 mg dexamethasone with 0.5 mg/kg of propofol. The 24 hour observation of PONV and need for rescue antiemetics were recorded at four occasions: at recovery and post operative periods of 1-6 hours, 7-12 hours and 13-24 hours. Results: Overall incidence of PONV in Group A and Group B was 20% and 16% respectively. There was no significant difference between the two groups in terms of PONV episodes and rescue antiemetics requirements. Significantly more patients in Group B had post operative drowsiness compared to Group A. No other side effects were noted in both groups during 24 hours observation period. Conclusion: The study showed that combination of dexamethasone 4 mg with subhypnotic dose of propofol 0.5 mg/kg was comparable to dexamethasone 8 mg in the prevention of post operative nausea and vomiting in patients undergoing laparoscopic gynaecological procedures.