DEXAMETHASONE PROPHYLAXIS BEFORE THYROIDECTOMY TO REDUCE POSTOPERATIVE NAUSEA, PAIN, AND VOCAL DYSFUNCTION: A RANDOMIZED CLINICAL CONTROLLED TRIAL

Background. The objective of this 2-arm, double-blind, randomized, controlled study was to assess the effects of a preoperative single dose steroid on postoperative nausea and vomiting (PONV), pain, and vocal function after thyroidectomy for benign disease. Methods. We randomized 102 patients into 2 groups from January to December 2009: (1) treatment with 8 mg/2 mL of dexamethasone and (2) treatment with 2 mL NaCl 0.9%, both administered intravenously before anesthesia. Results. The severity of nausea and the need for antiemetic drugs were reduced in patients receiving dexamethasone (p = .0001). Dexamethasone patients reported significantly less pain (p = .008); the need for analgesic drugs was lower in the dexamethasone group (p = .048). No differences were noted with regard to subjective voice analysis (p = .693). Conclusion. Dexamethasone (8 mg IV) is a safe and effective method to reduce PONV and pain after thyroid resection and should be used routinely. (C) 2010 Wiley Periodicals, Inc. Head Neck 33: 840-846, 2011