The Effect of Dexamethasone on Postoperative Nausea and Vomiting in Posterior Correction and Fusion Surgery for Adolescent Idiopathic Scoliosis
Seki, H.; Wakamiya, R.; Ihara, N.; Ideno, S.; Minoshima, R.; Murase, R.; Takagi, M.; Watanabe, K.; Sato, M.; Morisaki, H.
Masui. Japanese Journal of Anesthesiology 66(3): 298-302
2017
ISSN/ISBN: 0021-4892 PMID: 30380222 Document Number: 694397
Although dexamethasone is widely used to prevent postoperative nausea and vomiting (PONV) in both adults and children, the evidence in children is mainly from minor, short surgical proce- dures such as tonsillectomy and strabismus surgery. In this study, we reviewed medical re- cords of patients who had undergone posterior correc- tion and fusion surgery for adolescent idiopathic scoio- sis at our institution and evaluated the effect of dexa- methasone on PONV prophylaxis. Four of 11(36%) patients who had received prophylactic dexamethasone and 26 of 33 (79%) pa- tients who had not received dexamethasone developed PONV during the first 72 hours of surgery (OR 0.15 [95% CI : 0.04-0.681, P=0.02). Without dexametha- sone, 76% patients developed PONV within 24 hr of surgery. Although the incidence gradually declined, 24% of patients still developed PONV even later than 48 hr after surgery. In contrast the incidence of PONV during the first 24 hr in patients who had received dexamethasone was 36%, and none of them experi- enced PONV after 24 hr. The results of this study suggest that dexamethasone is effective in reducing PONV in chil- dren and adolescents undergoing posterior correction and fusion surgery for scoliosis. A randomized con- trolled trial is needed to confirm the findings of this study.