The Prophylactic Effect of Dexamethasone on Epidural Morphine-Related Nausea and Vomiting

Objective: To evaluate the prophylactic effect of dexamethasone on postoperative nausea and vomiting associated with epidural morphine. Methods: 120 women (n=40 in each of three groups) undergoing major elective gynecological surgery under epidural anesthesia were enrolled in this randomized, double-blinded, and placebo-controlled study. When the operation started, patients received IV dexamethasone 10 mg, ondansetron 8 mg and saline 2 mL, respectively. All patients received 2 mg epidural morphine bolus one hour before the end of surgery, followed by a continuous epidural infusion containing 0.12 mg/kg morphine in 100 mL bupivacaine 0.125% for postoperative analgesia for 48 hr. Analgesia, nausea and vomiting were evaluated. Results: The incidence of early and late nausea with vomiting in both dexamethasone group and ondansetron group was lower than in the saline (P0.05). There were no differences between dexamethasone and ondansetron (P0.05). Conclusions: Both dexamethasone and ondansetron reduced postoperative nausea and vomiting associated with epidural morphine, it suggests that dexamelhasone is a useful treatment in these patients.