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Dexamethasone for preventing nausea and vomiting associated with epidural morphine: a dose-ranging study
1Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei. painlab@tpts5.seed.net.tw
Anesthesia and Analgesia
|February 28, 2001
Summary
Dexamethasone effectively prevents nausea and vomiting after epidural morphine. A 5 mg dose is recommended as it is as effective as 10 mg but with potentially fewer side effects.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Postoperative nausea and vomiting (PONV) are common complications following surgery.
- Epidural morphine is frequently used for postoperative analgesia but can induce nausea and vomiting.
Purpose of the Study:
- To determine the optimal dose of dexamethasone for preventing nausea and vomiting after epidural morphine administration.
- To compare the efficacy of different dexamethasone doses and droperidol against a placebo.
Main Methods:
- A randomized, double-blind, placebo-controlled study involving 225 women undergoing hysterectomy.
- Patients received varying doses of intravenous dexamethasone (2.5 mg, 5 mg, 10 mg), droperidol (1.25 mg), or saline placebo after epidural morphine administration.
Main Results:
- Dexamethasone 5 mg and 10 mg, and droperidol 1.25 mg significantly reduced the incidence of nausea and vomiting compared to placebo.
- Dexamethasone 5 mg and 10 mg showed comparable efficacy, as did droperidol.
- Dexamethasone 2.5 mg was found to be ineffective in preventing nausea and vomiting.
Conclusions:
- Dexamethasone at 5 mg and 10 mg doses are effective antiemetics for preventing nausea and vomiting associated with epidural morphine.
- The 5 mg dose of dexamethasone is recommended due to its comparable efficacy to the 10 mg dose.