Efficacy of dexamethasone for reducing postoperative nausea and vomiting and analgesic requirements after thyroidectomy.

OBJECTIVE: To evaluate the efficacy of dexamethasone for reducing postoperative nausea and vomiting (PONV) and analgesic requirements after thyroidectomy. STUDY DESIGN AND SETTING: 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. RESULTS: 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). CONCLUSION: Dexamethasone 8 mg effectively decreases PONV and analgesic requirements after thyroidectomy.