Dexamethasone for prevention of postoperative nausea and vomiting in patients undergoing thyroidectomy: Meta-analysis of randomized controlled trials

Chia Che Chen, Fahad Javaid Siddiqui, Ta-Liang Chen, Edwin Shih Yen Chan, Ka-Wai Tam

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27 Citations (Scopus)

Abstract

Background Postoperative nausea and vomiting (PONV) is a common complication after thyroidectomy. Steroids effectively reduce nausea, pain, and inflammation; therefore, preoperative administration of steroids ought to improve these surgical outcomes. Methods We conducted a systematic review of randomized controlled trials (RCTs) that compared preoperative single-dose administration of dexamethasone with no dexamethasone in patients undergoing thyroidectomy. The primary outcome was occurrence of PONV within 24 h, and the secondary outcomes were pain, use of analgesics, and steroid-related complications. Results Five RCTs were included with a total of 497 patients. A statistically and clinically significant difference in the incidence of PONV was found in favor of dexamethasone [relative risk (RR) 0.38; 95% confidence interval (CI) 0.30-0.49). The visual analog pain score was significantly diminished (weighted mean difference, WMD)-1.50; 95% CI-2.54 to -0.46) at 24 h.The incidence of analgesics use was also reduced (RR 0.61; 95% CI 0.41-0.90) in the dexamethasone group. No steroid-related complications were noted. Conclusions A single preoperative administration of dexamethasone reduced the incidence of PONV and analgesic requirements in patients undergoing thyroidectomy. Prophylactic use of steroids for patients undergoing thyroidectomy is safe and should be considered for routine clinical practice.

Original languageEnglish
Pages (from-to)61-68
Number of pages8
JournalWorld Journal of Surgery
Volume36
Issue number1
DOIs
Publication statusPublished - 2012

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ASJC Scopus subject areas

  • Surgery

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