Propofol alone and combined with dexamethasone for the prevention of postoperative nausea and vomiting in adult Japanese patients having third molars extracted

We did a prospective, randomised, double-blind study to evaluate the efficacy and safety of a small dose of propofol alone, and propofol combined with dexamethasone, for the prevention of postoperative nausea and vomiting in adult Japanese patients listed for third molars extractions. One hundred and twenty patients, 55 men and 65 women aged 17-48 years, were given placebo, propofol 0.5mg/kg, or propofol 0.5mg/kg plus dexamethasone 8 mg intravenously at the end of the operation. A standard general anaesthestic was used, including sevoflurane and nitrous oxide in oxygen. Patients' characteristics were comparable in all three groups. The numbers of patients who developed postoperative nausea and vomiting during the 24h after anaesthesia were 8 with propofol (p=0.04), 2 with propofol plus dexamethasone (p=0.001), and 16 with placebo. The antiemetic efficacy of propofol combined with dexamethasone was superior to that of propofol alone (p=0.04). There were no clinically important adverse events. We conclude that a small dose (0.5mg/kg) of propofol combined with dexamethasone 8 mg was more effective than propofol alone for the prevention of postoperative nausea and vomiting in adult Japanese patients having general anaesthesia for extractions of third molars.