Antiemetic efficacy of dexmedetomidine versus dexmedetomidine-dexamethasone combination in patients undergoing breast surgery

J Int Med Res. 2019 Oct;47(10):5060-5069. doi: 10.1177/0300060519872031. Epub 2019 Sep 11.

Abstract

Objective: To compare the antiemetic efficacy of dexmedetomidine alone versus combined dexmedetomidine–dexamethasone on incidence of postoperative nausea and vomiting (PONV) in patients undergoing breast surgery.

Methods: A total of 149 patients (aged 20–65 years) were assigned to receive normal saline (control group, n = 50), dexmedetomidine 0.5 μg/kg (DEX group, n = 49), or a combination of dexmedetomidine 0.5 μg/kg and dexamethasone 5 mg (dual group, n = 50) at 30 minutes prior to the end of surgery. The primary outcome measure was the incidence of PONV in the post-anesthesia care unit (PACU).

Results: During the first 24 hours after surgery, the incidence of PONV was significantly higher in the control group than in the DEX and dual groups (70% vs. 20% and 12%, respectively), with no intergroup difference observed between the DEX and dual groups. In the PACU, the incidence of PONV differed significantly among the control, DEX, and dual groups (12%, 4%, and 3%, respectively).

Conclusion: Dexmedetomidine alone and in combination with dexamethasone significantly reduced PONV with similar antiemetic efficacies in female patients during the first 24 hours after breast surgery.

Clinical trial registration: ClinicalTrials.gov (NCT 02550795).

Keywords: Postoperative nausea and vomiting; antiemetic; breast surgery; dexamethasone; dexmedetomidine; prophylaxis.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Antiemetics / therapeutic use*
  • Breast Neoplasms / surgery*
  • Dexamethasone / therapeutic use*
  • Dexmedetomidine / therapeutic use*
  • Drug Therapy, Combination
  • Female
  • Hemodynamics
  • Humans
  • Incidence
  • Mastectomy*
  • Middle Aged
  • Postoperative Nausea and Vomiting / drug therapy
  • Postoperative Nausea and Vomiting / epidemiology
  • Young Adult

Substances

  • Antiemetics
  • Dexmedetomidine
  • Dexamethasone