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Anti-emetic effects of combined methylprednisolone and tropisetron in mastectomy.
MedLine Citation:
PMID:  23135693     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Combined dexamethasone and tropisetron has been reported more effective than a single drug therapy in preventing postoperative nausea and vomiting (PONV). However, the safety use of dexamethasone has been questioned recently because of the risk of secondary adrenal deficiency. Therefore, we hypothesized that combined tropisetron and methylprednisolone, a short-lasting corticoid, might provide effective prophylaxis of PONV with less effect on endogenous cortisol level. METHODS: In this study, 224 women undergoing modified radical mastectomy under general anesthesia were randomly divided into three groups: 1) receiving 10mg tropisetron alone (T, n=76), 2) 10mg tropisetron and 8mg dexamethasone (TD, n=73), or 3) 10mg tropisetron and 40mg methylprednisolone (TM, n=75) intravenously. Serum cortisol level, episodes of PONV and the need for rescue antiemetic medication were recorded during first 3 days after surgery. RESULTS: Serum cortisol significantly decreased in group TD (5.42±1.87μg/dL), compared with group TM (14.38±2.01μg/dL, P<0.01) and group T (19.52±1.53μg/dL, P<0.001) in the first day postoperatively. In the first 24 hours, the incidence of vomiting was significantly higher in group T (15.8%), compared with group TD (5.5%, P<0.05) and group TM (5.3%, P<0.05), respectively. The overall request for a rescue antiemetic of group T was significantly higher, compared with group TD and group TM (P<0.05). CONCLUSION: Methylprednisolone-tropisetron combination is more effective than tropisetron alone, and as equally effective as dexamethasone-tropisetron combination for preventing acute PONV in mastectomy.
Authors:
Q Yu; L Gao; M Gu; M Ma; Y Liu; W Zhu; J Zhang; W Liang
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-08
Journal Detail:
Title:  Minerva anestesiologica     Volume:  -     ISSN:  1827-1596     ISO Abbreviation:  Minerva Anestesiol     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375272     Medline TA:  Minerva Anestesiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Anesthesia, Huashan Hospital, Fudan University, Shanghai, China, 200040 - anesth.huashan@gmail.com.
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