Effect of Dexamethasone in Postoperative Symptoms After Mastectomy for Breast Cancer
Status:
Completed
Trial end date:
2010-05-01
Target enrollment:
Participant gender:
Summary
Postoperative pain, nausea and vomiting (PONV) are the most common complications after
anesthesia and surgery. Women undergoing mastectomy with axillary dissection are at a
particularly high risk for the development of PONV and an incidence of 60-80% in patients
receiving no antiemetic has been reported. Emetic episodes predispose to aspiration of
gastric contents, wound dehiscence, psychological distress, and delayed recovery and
discharge times. These justify the use of prophylactic antiemetics in women scheduled for
mastectomy. Most of the currently used antiemetics, including antihistamines, butyrophenones
and dopamine receptor antagonists have been reported to cause occasional undesirable adverse
effects, such as excessive sedation, hypotension, dry mouth, dysphoria, hallucinations and
extrapyramidal signs. Antiserotonins (e.g., ondansetron) are available for the prevention and
treatment of PONV in patients undergoing various types of surgery [4]. However, the use of
prophylactic antiemetic therapy with antiserotonins has been criticized for being too
expensive.
Dexamethasone was first reported to be an effective antiemetic regimen in patients receiving
cancer chemotherapy.
The purpose of this study was to evaluate the efficacy of dexamethasone treatment for
reducing pain and PONV as well as analgesic and antiemetic requirements in women undergoing
general anesthesia for mastectomy with axillary lymph node dissection.