Low-dose dexamethasone reduces nausea and vomiting after epidural morphine: a comparison of metoclopramide with saline.

STUDY OBJECTIVE

To compare the efficacy of a low dose of dexamethasone (5 mg) with metoclopramide 10 mg and saline in preventing nausea and vomiting after epidural morphine in posthysterectomy analgesia.

DESIGN

Randomized, placebo-controlled study.

SETTING

Inpatient surgery at Municipal Women's and Children's General Hospital.

PATIENTS

120 ASA physical status I and II women receiving epidural morphine for posthysterectomy analgesia.

INTERVENTIONS

All patients received epidural morphine 3 mg for postoperative analgesia. The dexamethasone group (n = 40) received dexamethasone 5 mg, the metoclopramide group (n = 40) received metoclopramide 10 mg, and the saline group (n = 40) received saline.

MEASUREMENTS AND MAIN RESULTS

The occurrence of nausea and vomiting appeared more frequently during 6 to 24 hours following the administration of epidural morphine. The total frequency of nausea and vomiting in the dexamethasone group was significantly lower than that of the metoclopramide and saline groups during this period, with reporting frequencies of 21%, 49%, and 53%, respectively (p <.05 each). However, the difference between metoclopramide and saline did not reach statistical significance.

CONCLUSIONS

Dexamethasone 5 mg was more effective than metoclopramide or saline in the prevention of nausea and vomiting associated with epidural morphine for postoperative analgesia.