• Akihiko Nonaka, Satomi Suzuki, Fumimasa Tamaki, Atsushi Furuya, Fumiaki Abe, and Takashi Matsukawa.
• Department of Anesthesia, Yamanashi Prefectural Central Hospital, Kofu 400-8506.
• Masui. 2008 Aug 1;57(8):978-82.

BackgroundThe authors evaluated the efficacy of a combination of dexamethasone and metoclopramide for the prophylaxis of postoperative nausea and vomiting (PONV) after gynecological abdominal surgery.MethodsOne-hundred and seventeen patients scheduled for gynecological abdominal surgery were analyzed retrospectively. Patients were classified into three groups by anti-emetics administered; none (Group C, n = 38); metoclopramide 10 mg (Group M, n = 39); or a combination of metoclopramide 10 mg with dexamethasone 8 mg (Group MD, n = 40) at 30 to 60 minutes prior to the end of surgery. Anesthesia was induced by propofol and maintained with isoflurane-nitrous oxide inhalation and intermittent administration of fentanyl. Postoperative pain was treated with continuous subcutaneous infusion of pentazocine via a patient controlled analgesia device. PONV was assessed using a 5 rating verbal score in early (0-6 hr) and in late (6-24 hr) period.ResultsThe 3 groups were similar in demographic characteristics. The incidence of nausea and vomiting in early period was significantly lower in Group MD compared with Group C and Group M. Rescue anti-emetic requirements were fewer in Group MD compared with Group C. There are no severe complications.ConclusionsA combination of metoclopramide and dexamethasone was more effective in preventing PONV compared with metoclopramide alone.

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