Dexamethasone prophylaxis before thyroidectomy to reduce postoperative nausea, pain, and vocal dysfunction: a randomized clinical controlled trial.

Author(s): Feroci F, Rettori M, Borrelli A, Lenzi E, Ottaviano A, Scatizzi M.

Affiliation(s): General Surgery Unit, Misericordia and Dolce Hospital, Prato, Italy. fferoci@yahoo.it

Publication date & source: 2011, Head Neck. , 33(6):840-6

BACKGROUND: The objective of this 2-arm, double-blind, randomized, controlled study was to assess the effects of a preoperative single dose steroid on postoperative nausea and vomiting (PONV), pain, and vocal function after thyroidectomy for benign disease. METHODS: We randomized 102 patients into 2 groups from January to December 2009: (1) treatment with 8 mg/2 mL of dexamethasone and (2) treatment with 2 mL NaCl 0.9%, both administered intravenously before anesthesia. RESULTS: The severity of nausea and the need for antiemetic drugs were reduced in patients receiving dexamethasone (p = .0001). Dexamethasone patients reported significantly less pain (p = .008); the need for analgesic drugs was lower in the dexamethasone group (p = .048). No differences were noted with regard to subjective voice analysis (p = .693). CONCLUSION: Dexamethasone (8 mg IV) is a safe and effective method to reduce PONV and pain after thyroid resection and should be used routinely.