Nausea and vomiting after dexamethasone versus droperidol following outpatient laparoscopy with a propofol-based general anesthetic

Background: The purpose of this randomized, double-blinded study was to compare the incidence and severity of postoperative nausea and vomiting (PONV) after dexamethasone versus droperidol following gynecologic laparoscopy, a group at high risk for developing PONV. Methods: Ninety-five patients who underwent a propofol-based general anesthetic received either dexamethasone 0.17 mg/kg IV, or droperidol 0.02 mg/kg IV, just prior to abdominal incision. Nausea, retching, vomiting, degree of sedation, and discharge times were assessed in the Post Anesthesia Care Unit (PACU), and the Ambulatory Care Unit (ACU). Following hospital discharge (24 h), the patients were contacted by telephone to assess any further complications. Results: PONV in the PACU (14.6% vs. 14.9%) and ACU (8.3% vs. 14.9%) was as common after dexamethasone as after droperidol. PONV following hospital discharge was, however, less common after dexamethasone than after droperidol (4.2% vs. 17.0%, P=0.041). Postoperatively, no complications of therapy were detected. Conclusions: We conclude that PONV is similar with dexamethasone and droperidol, but dexamethasone may have a longer duration of action in patients undergoing gynecologic laparoscopy.