Intravenous Dexamethasone for Preventing Postoperative Nausea and/or Vomiting in Total Abdominal Hysterectomy: A randomized double-blinded, placebo-controlled trial

Abstract

Objectives: To assess the efficacy of postoperative dexamethasone compared to placebo in reducing the incidence of postoperative nausea and/or vomiting (PONV) in women undergoing benign total abdominal hysterectomy (TAH).
Materials and Methods: Participants who were scheduled for TAH with or without adnexal surgery between August 2022 and April 2023 were included. The participants were randomly divided into two groups: the dexamethasone group (n = 43), who received 2 ml (8 mg) of intravenous dexamethasone injection, and the control group (n = 43) received 2 ml of normal saline at 2 hours after surgery.
Results: There was no significant difference in the incidence of PONV within 24 hours between the dexamethasone group and control group (32.6% vs 48.8%, relative risk 0.67(95% confidence interval 0.39 to 1.13), p = 0.09). The need for antiemetic drugs was not statistically different between groups (0% vs 9.3%, p = 0.05), and without serious adverse events in both groups. The dexamethasone group experienced a lesser pain score than the control group at 24 hours (4.7 ± 1.5 vs 5.8 ± 2.2, p = 0.01) after surgery. There was no difference in additional analgesic requirements.
Conclusion: The administration of 8 mg of intravenous dexamethasone postoperatively did not result in a significant reduction in PONV within the first 24 hours following benign TAH.