THE EFFECTS OF BETAMETHASONE ON REDUCING THE POSTOPERATIVE PAIN, NAUSEA, AND VOMITING

Pain, nausea, and vomiting are among common complications seen after different types of surgeries which need medical attention. In this study we tried to evaluate the effects of shortacting betamethasone on postoperative pain, nausea, and vomiting. In a period of 4 months, from February until May 2000, 60 females with American Society of Anesthesiologists (ASA) class I or II undergoing elective gynecologic surgeries were enrolled into this prospective study. These patients were randomly assigned into 2 equal groups of 30 each. The procedures of induction [diazepam (0.1 mg/kg), morphine (0.1 mg/kg), thiopental (5mg/kg), and atracurium (0.5 mg/kg)], and maintenance [1 % halothane and oxygen (3 L/min) together with N2O (3 L/min)] of anesthesia were the same for both groups. The study group received 8 mg of betamethasone IM just 10 min prior to the induction of anesthesia. We evaluated the frequency of postoperative pain of different intensities at 1st, 2nd, 3rd, 12th and 24th hr after the operation using verbal scores of 1 to 4 as follows: 1= no pain, 2= mild pain, 3= moderate pain, and 4= severe pain. At the same time, the frequencies of postoperative nausea and vomiting were determined in a similar fashion, scoring them from 1 to 3 as follows: 1= no nausea, 2= nausea, and 3= vomiting. Data were interpreted by Chi-square, Pearsonʹs, and Mantel-Haenszel tests, using SPSS software. P-values < 0.05 were considered as statistically significant. Patients of the study group experienced significantly less pain, nausea, and vomiting at the 1st, 2nd, and 3rd postoperative hours when compared to the control group. On the other hand, there was no significant difference between both groups at 12 th and 24th hr after the surgery. We found that a single dose of betamethasone, administered intramuscular IM 10 min prior to the induction of anesthesia, had an acceptable analgesic and antiemetic effect, lasting for at least 3 hr after surgery. Due to its effectiveness in reducing the frequency of postoperative pain, nausea, and vomiting, we recommend the preinduction use of betamethasone.