Sevoflurane with or without antiemetic prophylaxis of dexamethasone in spontaneously breathing patients undergoing outpatient anorectal surgery

Abstract

Study Objective: To evaluate the prophylactic use of dexamethasone with sevoflurane in outpatient anorectal surgery. Design: Randomized, controlled study. Setting: Operating room and Postanesthesia Care Unit of a general hospital. Patients: 60 adult, ASA physical status I and II outpatients undergoing anorectal surgery. Interventions: Patients were randomized to receive either dexamethasone 5 mg intravenously (IV; Group D; n = 30) or an equal volume of saline (Group S; n = 30) before anesthesia induction. Anesthesia was induced with propofol 2.5 mg.kg-1, fentanyl two μg.kg-1, and 2% lidocaine one mg.kg-1 followed by placement of a Laryngeal Mask Airway. Measurements: Frequency of postoperative nausea and vomiting (PONV), visual analog scale (VAS) pain scores, and patient satisfaction were recorded. Main Results: Frequency of PONV and VAS pain scores were significantly lower in Group D than Group S (P < 0.05). The time required for "home readiness" was significantly shorter in Group D than Group S (P < 0.05). Conclusions: The prophylactic administration of 5 mg dexamethasone IV can reduce the frequency of PONV, lower VAS pain scores, facilitate recovery to home readiness, and improve satisfaction in outpatients undergoing anorectal surgery. © 2009 Elsevier Inc. All rights reserved.