• Haiyang Zhou, Haitao Xu, Jian Zhang, Weijun Wang, Yi Wang, and Zhiqian Hu.
• Department of General Surgery, Changzheng Hospital, Second Military Medical University, No. 415 Fengyang Road, Shanghai 200003, People's Republic of China.
• World J Surg. 2012 Jun 1;36(6):1217-24.

BackgroundNausea, vomiting, and pain frequently occur after thyoidectomy. Little evidence exists regarding the effects of administrating a combination of dexamethasone and tropisetron to patients undergoing thyroidectomy. We aimed to evaluate the effects of dexamethasone and tropisetron on thyroidectomy outcomes.MethodsA total of 150 patients undergoing thyroidectomy were included in this prospective randomized, controlled, three-arm study (group D: 8 mg dexamethasone; group T: 5 mg tropisetron; group D+T: 8 mg dexamethasone and 5 mg tropisetron). There were 50 patients in each group. Nausea, vomiting, pain, and the amount of antiemetic and analgesic agents required were recorded 2, 4, 8, 16, 24, 36, and 48 h postoperatively.ResultsThe complete response rate of nausea and vomiting was significantly higher in group D+T (78%, 39/50), compared with that in group D (58%, 29/50) or group T (66%, 33/50) (P = 0.01). The incidence and severity of nausea in group D+T were significantly lower than in group D and group T, with the difference mainly occurring in the late postoperative period (6-48 h). The severity of postoperative pain was significantly less in the dexamethasone-containing groups (D and D+T groups) than in the tropisetron group.ConclusionsThe combination of dexamethasone and tropisetron offers better prophylaxis for nausea, vomiting, and pain than either drug alone in patients undergoing thyroidectomy, especially during the late period (6-48 h).

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