DOI: 10.1097/01.sa.0000203205.65812.65
,
Issn Print: 0039-6206
Publication Date: 2006/04/01
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Excerpt
Rashmi Madan,*† Anuj Bhatia,*‡ Sajith Chakithandy,*Rajeshwari Subramaniam,* Gurram Rammohan,*Shrinivas Deshpande,* Manorama Singh,* and H.L. Kaul*
(Anesth Analg, 100:1622-1626, 2005)
*Department of Anaesthesiology and Intensive Care, All India Institute of Medical Sciences, New Delhi, India; †Department of Anaesthetics, Queen Elizabeth Hospital, Norfolk and ‡Department of Anesthetics, Addenbrookes Hospital, Cambridge, United Kingdom.
The efficacy and safety of different doses of prophylactic intravenous dexamethasone for postoperative nausea and vomiting (PONV) were evaluated in a double-blind, randomized, placebo-controlled study of 168 children (aged 2-15 years) scheduled for strabismus surgery. Patients were given intravenous dexamethasone 0.25 mg/kg (D 0.25), 0.5 mg/kg (D 0.5), or 1.0 mg/kg (D 1) or saline (S) immediately after general anesthesia was induced. Patients were discharged 24 hours after surgery. Nausea and vomiting were assessed at 0 to 2, 2 to 6, and 6 to 24 hours after surgery. Blood glucose was measured preoperatively and at 4 hours after the administration of the study drug. Wound healing and infection were assessed after 1 week. More patients in group S had vomiting at 0 to 2, 2 to 6, and 6 to 24 hours 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. No marked increase in postoperative blood glucose levels was observed, and wound healing was satisfactory in all 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.
