Dexamethasone Single Dose and Risk of Postoperative Nausea and Vomiting in Tonsillectomy Patients

Introduction: Several meta-analyses investigating morbidity following tonsillectomy have demonstrated that under controlled conditions a single intravenous dose of Dexamethasone (DX) is an effective, safe and inexpensive method of reducing the incidence of postoperative nausea and vomiting (PONV) following tonsillectomy in children1-5. Unfortunately, there is substantial variability across these studies with respect to design, surgical technique, method of acquiring hemostasis and age of patients. We undertook the study to find out the effectiveness of a single IV dose of dexamethasone (0.15 mg/kg) on postoperative nausea and Vomiting (PONV) in tonsillectomy patients. Methods: This study was conducted with 100 patients who underwent tonsillectomy. Patients were divided into two groups of 50, where one group A (n=50) received preoperative dexamethasone and the other group B (n=50) were not given injection Dexamethasone Postoperative nausea and vomiting (PONV) episodes of both groups were recorded in first 6 hours, then next 6-24 hours and of 24 hours. Inj. metoclopromide 0.15 mg/kg was administered as rescue antiemetic, if more than two episodes of vomiting in an hour or nausea lasting for more than half hour occurred. If PONV still persisted, inj. ondansetron 0.1 mg/kg was administered as rescue antiemetic. Results: There is significant decreased in the incidence of PONV in first 6 hours in group A who were given IV dexamethasone compared to control group B and same trend was seen in next 6- 24 postoperative hours and also after 24 hours. Conclusions: A single dose of preoperative intravenous dexamethasone significantly decreased the postoperative nausea and vomiting in tonsillectomy patients.