Tumor lysis associated with dexamethasone use in a child with leukemia

Postoperative nausea and vomiting (PONV) occurs in every third patient undergoing general anesthesia without PONV prophylaxis. Antiemetic prophylaxis with dexamethasone is commonly used in patients at moderate risk. We present a case in which PONV prophylaxis with a single dose of dexamethasone led to tumor lysis in a patient with acute leukemia. In case of a cancer patient at moderate risk for PONV, the anesthesiologist should contact the oncologist first, or use other antiemetic drugs such as antiserotoninergic agents for PONV prophylaxis.