Beyond the Anti Emetic Effect of Dexamethasone

 Near Paso Robles, CA - photo by Andre Motie

 

Andre Motie, M.D.

Achieving a speedy PACU discharge, preventing nausea and vomiting, and controlling post-operative pain is a priority in outpatient surgery. A simple adjunct for achieving this goal is the use of a single dose of dexamethasone preoperatively or just after induction. Depending on the patient's size, I administer 4-10mg (average dose 8mg) intravenously. Single dose dexamethasone is associated with reduced pain scores, decreased fatigue, decreased nausea and vomiting, and a quicker discharge time. Patients also report a quicker return to their normal activities. Thus, their overall quality of recovery is improved.

Concerns related to routine steroid use center on wound healing and infectious complications. These theoretical risks are a concern in the elderly and sicker patients. However, these risks are not applicable to our greater patient population.

I routinely use the combination of Zofran and dexamethasone for nausea and vomiting prophylaxis. Beyond the known anti-emetic benefit, dexamethasone will improve your patient's overall quality of recovery.