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Original Article

The Effect of Dexamethasone in Tramadol Induced Nausea and Vomiting

Nurcin Gulhas, Mukadder Sanlı, Abdul Vahap Aslan, Ulku Ozgul, Murat Bıcakcıoglu, Mahmut Durmus

   

Abstract
We aimed to investigate the efficacy of a single dose bolus of dexamethasone on tramadol induced nausea and vomiting in our study. After approval was taken from ethics committee and patients, a total of 60 ASA I-II patients who were planned to undergo total abdominal hysterectomy (TAH) under general anesthesia were included in this study. A patient-controlled analgesia device was explained for the patients with preoperative visit. After the non-premedicated patients were taken in the operation room, the routine monitorization was performed. Induction was provided with 1μg/kg of fentanyl, 2 mg/kg propofol and 0.1 mg/kg vecuronium. 6-8% concentration of desflurane in a mixture of 50% air and 50% O2 was used for maintenance of anesthesia. When the incision was started to be closed, the patients were randomized into two groups by envelope method. 8 mg iv dexamethasone (2 mL) was given for Group D (n=30), iv Saline solution (2 mL) was given for Group K (n=30). After the incision was closed, a loading dose of intravenous tramadol 1 mg/kg was administered in both groups. The patients were taken in the postanesthesia care unit by extubating following the antagonism of muscle relaxant at the end of surgery. The patient-controlled analgesia device was scheduled to be as infusion: no, bolus: 12 mg, lock-out time: 10 min, 24 hour dosing limit: 400 mg. The pain and nausea and vomiting scores, additional analgesic and antiemetic requirements, the total amount of tramadol consumption were recorded at post-operative recovery and postoperative 2, 4, 6, 12 and 24 hours. Although the incidence of nausea and vomiting, and pain scores at 2 and 4 hours were not statistically significant, they were lower in Gorup D compared to Group K (p>0.05). 14 patients in Group K required additional antiemetics and 12 patients in Group D required additional antiemetics (p>0.05). Six patients in Group K required additional analgesics and 4 patients in Group D required additional analgesics. Although the total amount of tramadol consumption was not statistically significant, it was lower in Group D compared to Group K. It was concluded that a single bolus dose of dexamethasone 8 mg has not reduced tramadol induced nausea and vomiting in patients who were planned to undergo TAH.

Key words: Tramadol, nausea, vomiting, dexamethasone

Med-Science. 2016; 5(1): 94-101

Medicine Science Vol:5 Issue:1 Year:2016 PP:1–350
Posted in Vol: 5 Issue: 1 Year: 2016 March pp: 1–350

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