• Masaki Wakasugi, Masayuki Tori, Junzo Shimizu, Yong Kook Kim, Takehiro Noda, Keizo Dono, Yutaka Takeda, Tameyoshi Yamamoto, Satoshi Oshima, Yoshikazu Morimoto, Tadafumi Asaoka, Hidetoshi Eguchi, Hiroaki Nagano, Masaki Mori, Yuichiro Doki, and Hepato-Biliary-Pancreatic Group of the Clinical Study Group of Osaka University.
• Department of Surgery, Osaka Police Hospital, Osaka, Japan.
• J Hepatobiliary Pancreat Sci. 2015 Nov 1; 22 (11): 802-9.

BackgroundTo assess the efficacy of preoperative dexamethasone for postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy (LC) in Japan.MethodsA total of 270 patients at eight hospitals were randomized to receive dexamethasone 8 mg (n = 136) or placebo (n = 134) intravenously before LC. The primary endpoint was the degree of PONV and antiemetic requirements within 24 h after LC. Secondary endpoints were postoperative complications, postoperative hospital stay, and cost of hospital stay. This study was registered: UMIN-CTR (UMIN000003841).ResultsWithin 6 h after LC, 17% (23/136) of patients in the dexamethasone group versus 24% (32/134) in the placebo group reported nausea (P = 0.3), and 5% (7/136) versus 7% (10/134) reported vomiting (P = 0.2). Metoclopramide 10 mg was used 0.09 ± 0.31 versus 0.14 ± 0.35 times (P = 0.2). From 6 to 24 h, 10% (14/136) versus 13% (17/134) reported nausea (P = 0.5), and 5% (7/136) versus 5% (7/134) reported vomiting (P = 0.8). Metoclopramide was used 0.04 ± 0.19 versus 0.03 ± 0.17 times (P = 0.8). Postoperative complications and postoperative hospital stay did not differ significantly between the two groups, but the cost of hospital stay was slightly higher in the dexamethasone group (P < 0.05).ConclusionsRoutine use of preoperative dexamethasone for PONV after elective LC in Japan was not shown to have a clinical advantage.© 2015 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

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