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Effect of dexamethasone on prevention of postoperative nausea, vomiting and pain after caesarean section: a randomised, placebo-controlled, double-blind trial.
Eur J Anaesthesiol. 2013 Mar; 30(3):102-5.EJ

Abstract

CONTEXT

Spinal morphine is a common form of postoperative analgesia after caesarean section, but it is associated with postoperative nausea and vomiting.

OBJECTIVE

To evaluate the hypothesis that dexamethasone reduces nausea and vomiting in patients undergoing caesarean section under spinal anaesthesia with morphine.

DESIGN

Interventional, randomised, double-blinded, placebo-controlled study to evaluate a preoperative single dose of dexamethasone.

SETTING

Patients from a tertiary hospital in the city of Sao Paulo, Sao Paulo, Brazil observed from 1 January through 30 June 2008.

PATIENTS OR OTHER PARTICIPANTS

Seventy full-term pregnant patients (American Society of Anesthesiologists 1 or 2) were studied. Patients were randomly allocated into two groups determined by a computerised table. Exclusion criteria were contraindication to regional anaesthesia, allergy to dexamethasone, opioids or local anaesthetics, hypertension or diabetes originated during pregnancy and use of any antiemetic drug received before surgery. Spinal anaesthesia consisted of hyperbaric bupivacaine and morphine.

INTERVENTION

Patients received either dexamethasone 10 mg in 100 ml of isotonic saline, intravenously or 100 ml of isotonic saline (placebo) prior to surgery.

MAIN OUTCOME

Incidence of postoperative nausea and vomiting in the first 24 h were rated and recorded. Pain scores at rest and on movement were evaluated using a visual analogue scale.

RESULTS

During the first 24 hours, nausea occurred in 12/35 (34.4%) patients receiving dexamethasone and in 32/35 (91.4%) receiving placebo (P<0.001). During the same time period, vomiting occurred in 12/35 (34.4%) patients receiving dexamethasone and in 29/35 (82.9%) receiving placebo (P<0.001). Pain at rest and pain on movement was lower in patients who received dexamethasone at some time points during the study period.

CONCLUSION

Dexamethasone reduced the cumulative incidence of nausea and vomiting after caesarean section under spinal anaesthesia with morphine and lowered pain scores on the first postoperative day.

Authors+Show Affiliations

Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23022704

Citation

Cardoso, Monica M S., et al. "Effect of Dexamethasone On Prevention of Postoperative Nausea, Vomiting and Pain After Caesarean Section: a Randomised, Placebo-controlled, Double-blind Trial." European Journal of Anaesthesiology, vol. 30, no. 3, 2013, pp. 102-5.
Cardoso MM, Leite AO, Santos EA, et al. Effect of dexamethasone on prevention of postoperative nausea, vomiting and pain after caesarean section: a randomised, placebo-controlled, double-blind trial. Eur J Anaesthesiol. 2013;30(3):102-5.
Cardoso, M. M., Leite, A. O., Santos, E. A., Gozzani, J. L., & Mathias, L. A. (2013). Effect of dexamethasone on prevention of postoperative nausea, vomiting and pain after caesarean section: a randomised, placebo-controlled, double-blind trial. European Journal of Anaesthesiology, 30(3), 102-5. https://doi.org/10.1097/EJA.0b013e328356676b
Cardoso MM, et al. Effect of Dexamethasone On Prevention of Postoperative Nausea, Vomiting and Pain After Caesarean Section: a Randomised, Placebo-controlled, Double-blind Trial. Eur J Anaesthesiol. 2013;30(3):102-5. PubMed PMID: 23022704.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of dexamethasone on prevention of postoperative nausea, vomiting and pain after caesarean section: a randomised, placebo-controlled, double-blind trial. AU - Cardoso,Monica M S, AU - Leite,Alexandre O, AU - Santos,Elisa A, AU - Gozzani,Judymara L, AU - Mathias,Lígia A S T, PY - 2012/10/2/entrez PY - 2012/10/2/pubmed PY - 2013/8/2/medline SP - 102 EP - 5 JF - European journal of anaesthesiology JO - Eur J Anaesthesiol VL - 30 IS - 3 N2 - CONTEXT: Spinal morphine is a common form of postoperative analgesia after caesarean section, but it is associated with postoperative nausea and vomiting. OBJECTIVE: To evaluate the hypothesis that dexamethasone reduces nausea and vomiting in patients undergoing caesarean section under spinal anaesthesia with morphine. DESIGN: Interventional, randomised, double-blinded, placebo-controlled study to evaluate a preoperative single dose of dexamethasone. SETTING: Patients from a tertiary hospital in the city of Sao Paulo, Sao Paulo, Brazil observed from 1 January through 30 June 2008. PATIENTS OR OTHER PARTICIPANTS: Seventy full-term pregnant patients (American Society of Anesthesiologists 1 or 2) were studied. Patients were randomly allocated into two groups determined by a computerised table. Exclusion criteria were contraindication to regional anaesthesia, allergy to dexamethasone, opioids or local anaesthetics, hypertension or diabetes originated during pregnancy and use of any antiemetic drug received before surgery. Spinal anaesthesia consisted of hyperbaric bupivacaine and morphine. INTERVENTION: Patients received either dexamethasone 10 mg in 100 ml of isotonic saline, intravenously or 100 ml of isotonic saline (placebo) prior to surgery. MAIN OUTCOME: Incidence of postoperative nausea and vomiting in the first 24 h were rated and recorded. Pain scores at rest and on movement were evaluated using a visual analogue scale. RESULTS: During the first 24 hours, nausea occurred in 12/35 (34.4%) patients receiving dexamethasone and in 32/35 (91.4%) receiving placebo (P<0.001). During the same time period, vomiting occurred in 12/35 (34.4%) patients receiving dexamethasone and in 29/35 (82.9%) receiving placebo (P<0.001). Pain at rest and pain on movement was lower in patients who received dexamethasone at some time points during the study period. CONCLUSION: Dexamethasone reduced the cumulative incidence of nausea and vomiting after caesarean section under spinal anaesthesia with morphine and lowered pain scores on the first postoperative day. SN - 1365-2346 UR - https://www.unboundmedicine.com/medline/citation/23022704/Effect_of_dexamethasone_on_prevention_of_postoperative_nausea_vomiting_and_pain_after_caesarean_section:_a_randomised_placebo_controlled_double_blind_trial_ L2 - https://doi.org/10.1097/EJA.0b013e328356676b DB - PRIME DP - Unbound Medicine ER -