Low-dose dexamethasone effectively prevents postoperative nausea and vomiting after ambulatory laparoscopic surgery

Purpose: To evaluate the prophylactic effect of low-dose dexamethasone (5 m g) on postoperative nausea and vomiting (PONV) in women undergoing ambulato ry laparoscopic surgery. Metoclopramide and saline served as controls. Methods: One hundred twenty women (n = 40 in each of the three groups) unde rgoing ambulatory laparoscopic tubal ligation under general anesthesia were enrolled in this randomized, double-blinded, placebo-controlled study. Aft er tracheal intubation, group I received iv dexamethasone 5 mg, whereas gro ups II and III received iv metoclopramide 10 mg and saline, respectively. Results: Patients in group I reported a lower incidence of PONV and request ed less rescue antiemetics than those in group III during the first four po stoperative hours (P < 0.01). Patients in group I reported a lower incidenc e of PONV than those in groups II (P < 0.05) and III (P < 0.01) during the 24-hr postoperative period. Groups II and III did not differ from each othe r in the incidence of PONV and the proportion of patients who requested res cue antiemetics. Conclusion: Prophylactic iv dexamethasone 5 mg significantly reduces the in cidence of PONV in women undergoing ambulatory laparoscopic tubal ligation. At this dose, dexamethasone is more effective than metoclopramide 10 mg or placebo.