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