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  • Title: Reduction of postoperative emetic episodes and analgesic requirements with dexamethasone in patients scheduled for dental surgery.
    Author: Numazaki M, Fujii Y.
    Journal: J Clin Anesth; 2005 May; 17(3):182-6. PubMed ID: 15896584.
    Abstract:
    STUDY OBJECTIVE: To evaluate the antiemetic and analgesic effects of dexamethasone for the first 24 hours postoperatively in patients scheduled for dental surgery. DESIGN: Prospective, randomized, double-blind, placebo-controlled study. SETTING: University hospital. PATIENTS: One hundred twenty ASA physical status I and II patients (45 men, 75 women; aged 17-48 years) undergoing general anesthesia for dental surgery. INTERVENTIONS: Patients received intravenously placebo or dexamethasone at 3 different doses (4, 8, or 16 mg) at the end of the surgical procedure. A standard general anesthetic technique, including sevoflurane and nitrous oxide in oxygen, was used. MEASUREMENT AND MAIN RESULTS: Emetic episodes and analgesic requirements were evaluated. The rate of patients who were emesis free (no nausea, retching, or vomiting) during 0 to 24 hours after anesthesia was 63% with dexamethasone 4 mg (P = NS), 83% with dexamethasone 8 mg (P < .05), and 90% with dexamethasone 16 mg (P < .05), compared to placebo (60%). The need for diclofenac sodium for intolerable pain was less in patients who had received dexamethasone 8 mg or dexamethasone 16 mg than in those who had received placebo or dexamethasone 4 mg (P < .05). No clinically important adverse events were observed in any group. CONCLUSIONS: Prophylactic dexamethasone 8 mg is effective for the prevention of nausea and vomiting after dental surgery and in the management of postoperative pain. Increasing the dose to 16 mg provides no further benefit.
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