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

by Jyh I. Wu, Shao Fong Lu, Yuan Yi Chia, Lin Cheng Yang, Wen Po Fong, Ping Heng Tan
Journal of Clinical Anesthesia ()

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.

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