• R McKenzie, T J Riley, B Tantisira, and D L Hamilton.
• Department of Anesthesiology, Magee-Womens Hospital, Pittsburgh, PA 15213, USA.
• J Clin Anesth. 1997 Feb 1;9(1):15-20.

Study ObjectivesTo test the hypothesis that for major gynecologic surgery the combination of propofol for induction, ondansetron, and dexamethasone would be a more effective antiemetic combination than propofol for induction, ondansetron, and saline; and to determine if a propofol induction of anesthesia improved our previously reported results when thiamylal was the induction drug.DesignDouble-blind, randomized study.SettingMagee-Womens Hospital, Pittsburgh, Pennsylvania.Patients80 healthy ASA physical status I, II, and III female inpatients scheduled for major gynecologic surgery.InterventionsAfter induction of anesthesia with propofol, Group 1 received intravenous (IV) ondansetron 4 mg and saline, and Group 2 received IV ondansetron 4 mg followed by IV dexamethasone 20 mg.Measurements And Main ResultsFor Group 1 and Group 2, respectively, no emesis and no rescue occurred in 15 (37.5%) and 21 (52.5%) patients (p = 0.13); emesis occurred in 7 (17.5%) Group 1 patients and 5 (12.5%) Group 2 patients, rescue antiemetic 23 (57.5%) Group 1 patients and 19 (47.5%) Group 2 patients. Nausea was reported by 31 (77.5%) Group 1 patients and 30 (75%) Group 2 patients.ConclusionsThe hypothesis that the addition of dexamethasone to the propofolondansetron combination would significantly reduce postoperative nausea and vomiting (PONV) was not confirmed. A propofol induction of anesthesia resulted in a comparable incidence of PONV when compared with our previously reported results using thiamylal for induction of anesthesia for women having major gynecologic operations.

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