Methylprednisolone vs. dexamethasone in the prevention of postoperative nausea and vomiting: a prospective, randomised, double-blind, placebo-controlled trial.

Dexamethasone and methylprednisolone have been proven effective in the prevention of nausea after chemotherapy. Dexamethasone has been proven effective in the prophylaxis of late PONV. Literature about methylprednisolone in PONV prophylaxis is rare. We randomized 118 patients in a double blind way to receive either dexamethasone 8 mg, methylprednisolone 40 mg or placebo as prophylactic agent. Duration of anaesthesia was significantly longer and significantly more sufentanil was used in the methylprednisolone group. Despite these 2 risk factors, methylprednisolone was significantly better than placebo in the prevention of late nausea, retching and PONV. There was a beneficial clinical effect of dexamethasone in this population, although not significant. A possible explanation lies in the fact that monotherapy is mostly insufficient in a population at risk like ours. This study confirms that steroids are mostly effective in the prevention of late PONV, less effective in early PONV.

RCT Entities:   Population Interventions Outcomes