Prophylactic effects of a combination of droperidol and dexamethasone on nausea and vomiting after middle ear surgery

Purpose To evaluate the antiemetic effect and safety of a small dose of droperidol and dexamethasone in adults undergoing middle ear surgery.Methods One hundred and twenty ASAⅠ-Ⅱpatients scheduled for middle ear surgery under general anesthesia were included.The anesthetic technique was standardized and the surgeon groups were fixed.Patients were randomly assigned to receive droperidol(1.25 mg),dexamethasone(10mg),droperidol(1.25 mg) plus dexamethasone(10 mg),or placebo(0.9%NaCl),respectively.The incidence of postoperative nausea and vomiting(PONV),the requirement for rescue antiemetics and side effects were recorded by a blinded observer.Results During the first 6h after operation,the combination of droperidol and dexamethasone was as effective as droperidol alone,and more effective than either dexamethasone alone or placebo.There was no statistical difference between dexamethasone group and placebo group in the incidence of PONV and the requirement for rescue antiemetics.During the following 18 h(6-24 h),the incidence of PONV was significantly lower in the combination group than in the placebo group.No clinically adverse events were observed in any groups.Conclusions The prophylactic use of a small dose of droperidol may reduce PONV during the first 6 h after middle ear surgery.A combination of droperidol and dexamethasone is an effective,safe and cheap choice to prevent PONV for 24 h after middle ear surgery.