Benefits of dexamethasone use in thyroid surgery – a prospective, randomized study

Abstract

Introduction/Objective This study aimed to investigate the effects of preoperative dexamethasone use on the incidence and severity of postoperative nausea and vomiting (PONV), postsurgical pain, and vocal impairment after thyroid surgery.

Methods We performed a prospective, randomized, double-blind study with 50 patients who underwent thyroid surgery. Group A patients (n = 25) received 0.9% NaCl solution (2 ml) before anesthesia, patients in Group B (n = 25) were administered 8 mg of dexamethasone. All the patients preoperatively received 4 mg of ondansetron. During the first 48 hours after surgery, postoperative complications were monitored in defined periods.

Results PONV rate and severity was significantly lower in Group B than in Group A (p < 0.05). Patients in Group B reported less pain in resting and in activity (p < 0.05) and lower vocal impairment (p < 0.05) than patients in Group A in each defined time period.

Conclusion Preoperatively adding dexamethasone to ondansetron is more effective than use of ondansetron alone in the prevention of PONV. Dexamethasone significantly reduces the pain and improves voice function; therefore, we could advise routine single-dose dexamethasone use before thyroid surgery.

Keywords: PONV; postoperative pain; vocal impairment; thyroid surgery; dexamethasone; ondansetron