Sevoflurane with or without antiemetic prophylaxis of dexamethasone in spontaneously breathing patients undergoing outpatient anorectal surgery

Wu, Jyh-I; Lu, Shao-Fong; Chia, Yuan-Yi; Yang, Lin-Cheng; Fong, Wen-Po; Tan, Ping-Heng

doi:10.1016/j.jclinane.2008.11.007

« Previous Next »Journal of Clinical Anesthesia
Volume 21, Issue 7 , Pages 469-473, November 2009

Sevoflurane with or without antiemetic prophylaxis of dexamethasone in spontaneously breathing patients undergoing outpatient anorectal surgery☆

Jyh-I Wu, MD (Visiting Anesthesiologist)
- Department of Anesthesia, Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung 80276, Taiwan
Shao-Fong Lu, MD (Visiting Anesthesiologist)
- Department of Anesthesiology, Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung 83307, Taiwan
Yuan-Yi Chia, MD (Associate Professor)
- Department of Anesthesiology, Kaohsiung Veterans General Hospital and School of Medicine, National Yang-Ming University, Kaohsiung 81346, Taiwan
Lin-Cheng Yang, MD (Associate Professor)
- Department of Anesthesiology, E-DA Hospital/I-Shou University, Kaohsiung 82445, Taiwan
Wen-Po Fong, MD (Visiting Anesthesiologist)
- Department of Anesthesia, Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung 80276, Taiwan
Ping-Heng Tan, MD, PhD (Associate Professor)
- Department of Anesthesiology, E-DA Hospital/I-Shou University, Kaohsiung 82445, Taiwan
- Department of Biomedical Engineering, E-DA Hospital/I-Shou University, Kaohsiung 82445, Taiwan
- Corresponding author. LN 183, Rong-Jong Rd., Kaohsiung 813, Taiwan. Tel.: +886 7 347 7902; fax: +886 7 342 3348.

Received 12 September 2007; received in revised form 3 November 2008; accepted 10 November 2008. published online 07 September 2009.

Abstract

Study Objective

To evaluate the prophylactic use of dexamethasone with sevoflurane in outpatient anorectal surgery.

Design

Randomized, controlled study.

Setting

Operating room and Postanesthesia Care Unit of a general hospital.

Patients

60 adult, ASA physical status I and II outpatients undergoing anorectal surgery.

Interventions

Patients were randomized to receive either dexamethasone 5 mg intravenously (IV; Group D; n = 30) or an equal volume of saline (Group S; n = 30) before anesthesia induction. Anesthesia was induced with propofol 2.5 mg.kg⁻¹, fentanyl two μg.kg⁻¹, and 2% lidocaine one mg.kg⁻¹ followed by placement of a Laryngeal Mask Airway.

Measurements

Frequency of postoperative nausea and vomiting (PONV), visual analog scale (VAS) pain scores, and patient satisfaction were recorded.

Main Results

Frequency of PONV and VAS pain scores were significantly lower in Group D than Group S (P < 0.05). The time required for “home readiness” was significantly shorter in Group D than Group S (P < 0.05).

Conclusions

The prophylactic administration of 5 mg dexamethasone IV can reduce the frequency of PONV, lower VAS pain scores, facilitate recovery to home readiness, and improve satisfaction in outpatients undergoing anorectal surgery.

Keywords: Anorectal surgery, Dexamethasone, Postoperative nausea and vomiting, Sevoflurane