TY - JOUR
T1 - Efficacy of preoperative dexamethasone for postoperative nausea and vomiting after laparoscopic cholecystectomy
T2 - A large-scale, multicenter, randomized, double-blind, placebo-controlled trial in Japan
AU - Wakasugi, Masaki
AU - Tori, Masayuki
AU - Shimizu, Junzo
AU - Kim, Yong Kook
AU - Noda, Takehiro
AU - Dono, Keizo
AU - Takeda, Yutaka
AU - Yamamoto, Tameyoshi
AU - Oshima, Satoshi
AU - Morimoto, Yoshikazu
AU - Asaoka, Tadafumi
AU - Eguchi, Hidetoshi
AU - Nagano, Hiroaki
AU - Mori, Masaki
AU - Doki, Yuichiro
PY - 2015/11
Y1 - 2015/11
N2 - Background To assess the efficacy of preoperative dexamethasone for postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy (LC) in Japan. Methods A total of 270 patients at eight hospitals were randomized to receive dexamethasone 8 mg (n = 136) or placebo (n = 134) intravenously before LC. The primary endpoint was the degree of PONV and antiemetic requirements within 24 h after LC. Secondary endpoints were postoperative complications, postoperative hospital stay, and cost of hospital stay. This study was registered: UMIN-CTR (UMIN000003841). Results Within 6 h after LC, 17% (23/136) of patients in the dexamethasone group versus 24% (32/134) in the placebo group reported nausea (P = 0.3), and 5% (7/136) versus 7% (10/134) reported vomiting (P = 0.2). Metoclopramide 10 mg was used 0.09 ± 0.31 versus 0.14 ± 0.35 times (P = 0.2). From 6 to 24 h, 10% (14/136) versus 13% (17/134) reported nausea (P = 0.5), and 5% (7/136) versus 5% (7/134) reported vomiting (P = 0.8). Metoclopramide was used 0.04 ± 0.19 versus 0.03 ± 0.17 times (P = 0.8). Postoperative complications and postoperative hospital stay did not differ significantly between the two groups, but the cost of hospital stay was slightly higher in the dexamethasone group (P < 0.05). Conclusions Routine use of preoperative dexamethasone for PONV after elective LC in Japan was not shown to have a clinical advantage. Highlight Wakasugi and colleagues set out to evaluate the prophylactic efficacy of preoperative dexamethasone for postoperative nausea and vomiting after elective laparoscopic cholecystectomy. Preoperative dexamethasone showed no clinical advantage, as it failed to significantly reduce the incidence of postoperative nausea and vomiting, while it increased the cost of hospital stay.
AB - Background To assess the efficacy of preoperative dexamethasone for postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy (LC) in Japan. Methods A total of 270 patients at eight hospitals were randomized to receive dexamethasone 8 mg (n = 136) or placebo (n = 134) intravenously before LC. The primary endpoint was the degree of PONV and antiemetic requirements within 24 h after LC. Secondary endpoints were postoperative complications, postoperative hospital stay, and cost of hospital stay. This study was registered: UMIN-CTR (UMIN000003841). Results Within 6 h after LC, 17% (23/136) of patients in the dexamethasone group versus 24% (32/134) in the placebo group reported nausea (P = 0.3), and 5% (7/136) versus 7% (10/134) reported vomiting (P = 0.2). Metoclopramide 10 mg was used 0.09 ± 0.31 versus 0.14 ± 0.35 times (P = 0.2). From 6 to 24 h, 10% (14/136) versus 13% (17/134) reported nausea (P = 0.5), and 5% (7/136) versus 5% (7/134) reported vomiting (P = 0.8). Metoclopramide was used 0.04 ± 0.19 versus 0.03 ± 0.17 times (P = 0.8). Postoperative complications and postoperative hospital stay did not differ significantly between the two groups, but the cost of hospital stay was slightly higher in the dexamethasone group (P < 0.05). Conclusions Routine use of preoperative dexamethasone for PONV after elective LC in Japan was not shown to have a clinical advantage. Highlight Wakasugi and colleagues set out to evaluate the prophylactic efficacy of preoperative dexamethasone for postoperative nausea and vomiting after elective laparoscopic cholecystectomy. Preoperative dexamethasone showed no clinical advantage, as it failed to significantly reduce the incidence of postoperative nausea and vomiting, while it increased the cost of hospital stay.
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U2 - 10.1002/jhbp.285
DO - 10.1002/jhbp.285
M3 - Article
C2 - 26288165
AN - SCOPUS:84945278881
VL - 22
SP - 802
EP - 809
JO - Journal of Hepato-Biliary-Pancreatic Sciences
JF - Journal of Hepato-Biliary-Pancreatic Sciences
SN - 1868-6974
IS - 11
ER -