• Y Miyagawa, M Ejiri, T Kuzuya, T Osada, N Ishiguro, and K Yamada.
• Department of Hospital Pharmacy, Nagoya University Hospital, Showa-ku, Nagoya, Japan. y-miyaga@med.nagoya-u.ac.jp
• J Clin Pharm Ther. 2010 Dec 1;35(6):679-84.

What Is Known And ObjectiveTotal knee and hip joint replacement has a high risk of postoperative nausea and vomiting (PONV), and steroid cover is used for cases associated with autoimmune diseases. Our aim is to evaluate the antiemetic efficacy of methylprednisolone as steroid cover in patients undergoing the surgery.MethodsA prospective cohort study design was used. Sixty-eight patients, aged between 20 and 80 years, were scheduled for a standardized general anaesthetic technique. Patients who were given methylprednisolone were assigned as the steroid cover group, and those who were not given methylprednisolone formed the non-steroid cover group. PONV were assessment by direct questioning or spontaneous complaints by patients 1 week after surgery. Postoperative pain was evaluated using Visual Analog Scale (VAS) 1 and 3 days after surgery.Results And DiscussionThe incidence of nausea in the steroid cover group was significantly less than that in the non-steroid cover group (adjusted odds ratio, 0·17, P = 0·021), but there was no significant difference in vomiting between the two groups. Postoperative pain VAS score was not significantly different between groups.What Is New And ConclusionIn total knee and hip arthroplasty, methylprednisolone is effective in preventing postoperative nausea; however, higher doses of methylprednisolone may be needed to prevent vomiting.© 2010 Blackwell Publishing Ltd.

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