The Quality of Recovery after Dexamethasone, Ondansetron, or Placebo Administration in Patients Undergoing Lower Limbs Orthopedic Surgery under Spinal Anesthesia Using Intrathecal Morphine. A Randomized Controlled Trial

Anesthesiology Research and Practice
Eduardo Toshiyuki MoroJoshua Bloomstone

Abstract

Intrathecal morphine is widely and successfully used to prevent postoperative pain after orthopedic surgery, but it is frequently associated with side effects. The aim of this study was to evaluate the effect of dexamethasone or ondansetron when compared to placebo to reduce the occurrence of these undesirable effects and, consequently, to improve the quality of recovery based on patient's perspective. Methods. One hundred and thirty-five patients undergoing lower extremity orthopedic surgery under spinal anesthesia using bupivacaine and morphine were randomly assigned to receive IV dexamethasone, ondansetron, or saline. On the morning following surgery, a quality of recovery questionnaire (QoR-40) was completed. Results. No differences were detected in the global and dimensional QoR-40 scores following surgery; however, following postanesthesia care unit (PACU) discharge, pain scores were higher in patients receiving ondansetron compared with patients who received dexamethasone. Conclusion. Neither ondansetron nor dexamethasone improves the quality of recovery after lower limbs orthopedic surgery under spinal anesthesia using intrathecal morphine.

References

Jun 22, 1974·British Medical Journal·M A RamsayR Goodwin
Sep 1, 1994·British Journal of Anaesthesia·K TörnL Lindgren
Mar 31, 2000·British Journal of Anaesthesia·P S MylesS Hensen
Sep 14, 2012·The Cochrane Database of Systematic Reviews·James D GriffithsJane Thomas
Dec 12, 2012·Anesthesia and Analgesia·Gildasio S De OliveiraRobert J McCarthy
Oct 10, 2013·Journal of Anaesthesiology, Clinical Pharmacology·Kamal Kumar, Sudha Indu Singh
Dec 21, 2013·Anesthesia and Analgesia·Tong J GanUNKNOWN Society for Ambulatory Anesthesia

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Methods Mentioned

BETA
total hip arthroplasty
sedation
hysterectomy
cesarean section

Clinical Trials Mentioned

NCT03035942

Software Mentioned

SPSS Statistics

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