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To evaluate the efficacy of dexamethasone for reducing postoperative nausea and vomiting (PONV) and analgesic requirements after thyroidectomy.In a prospective, randomized, double-blind, placebo-controlled study, 75 patients, 20 men and 55 women, received intravenously placebo or dexamethasone at 2 different doses (4 and 8 mg) (n = 25 of each) at the end of surgery. A standard general anesthetic technique was used. PONV and analgesic requirements were evaluated.The rate of patients experiencing PONV during the first 24 hours after anesthesia was 64% with dexamethasone 4 mg (P = 0.269) and 28% with dexamethasone 8 mg (P = 0.001), compared with placebo (76%). The need of indomethacin for intolerable pain was less in patients who had received dexamethasone 8 mg than in those who had received placebo (P = 0.009).Dexamethasone 8 mg effectively decreases PONV and analgesic requirements after thyroidectomy.