Publication: Efficacy of intravenous dexamethasone for the prevention of vomiting associated with intrathecal chemotherapy and ketamine sedation in children: A randomized, double-blinded, crossover, placebo-controlled trial
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Issued Date
2011-08-01
Resource Type
ISSN
1875855X
19057415
19057415
Other identifier(s)
2-s2.0-84871653077
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Mahidol University
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SCOPUS
Bibliographic Citation
Asian Biomedicine. Vol.5, No.4 (2011), 441-448
Suggested Citation
Chanchai Traivaree, Kitti Torcharus, Rachata Lumkul, Chulalak Komoltri, Somrat Charuluxananan Efficacy of intravenous dexamethasone for the prevention of vomiting associated with intrathecal chemotherapy and ketamine sedation in children: A randomized, double-blinded, crossover, placebo-controlled trial. Asian Biomedicine. Vol.5, No.4 (2011), 441-448. doi:10.5372/1905-7415.0504.058 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/11504
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Title
Efficacy of intravenous dexamethasone for the prevention of vomiting associated with intrathecal chemotherapy and ketamine sedation in children: A randomized, double-blinded, crossover, placebo-controlled trial
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Abstract
Background: Chemotherapy-induced nausea and vomiting remains a significant problem for children with leukemia. There is limited evidence to support using prophylactic antiemetic prior to the administration of intrathecal chemotherapy. Objective: Determine whether vomiting and nausea associated with intravenous ketamine and intrathecal chemotherapy may be reduced by the addition of prophylactic dexamethasone in children. Method: A randomized, double-blinded, crossover, placebo-controlled trial was completed in 33 children receiving intrathecal chemotherapy with methotrexate and ketamine sedation at Pharmongkutklao Hospital. Patients were randomly assigned in a double-blinded fashion to receive one of two interventions during the first period, either an infusion of normal saline or intravenous dexamethasone at 0.25 mg/kg/dose. Each patient acted as his or her own control, and each patient was studied at two time-points. Results: Period effect, sequence effect, and carry over effect were not demonstrated. The absolute risk reduction of vomiting was significantly greater after infusion of dexamethasone than after placebo at 33.3% (p=0.02). The number needed to treat was three to prevent one episode of vomiting. Fifteen patients in the treatment group reported nausea versus 26 patients in the placebo group (p= 0.007). In the group of patients treated with dexamethasone, five required antiemetic vs. 16 of those receiving placebo (p=0.02). There was no complication from dexamethasone. Conclusion: Intravenous dexamethasone reduced vomiting associated with intrathecal chemotherapy and ketamine sedation, without significant side-effects. It may be recommended a reasonable option before intrathecal chemotherapy.