The Effect of Dexamethasone on Postoperative Vomiting, Parenteral Fluid and Oral Intake after Tonsillectomy

Abstract

Background: Vomiting is a common postoperative complication of tonsillectomy causing patients' discomfort, delay in hospital discharge and seldom pulmonary aspiration. The incidence of postoperative emesis is higher in pediatrics population and increases with age to reach a peak in preadolescence (ages 11-14 years). Objectives: To determine the effectiveness of single dose intravenous dexamethasone, at induction of anesthesia, on postoperative emesis, starting oral intake and the period of intra venous fluid.Patients and Method: In a randomized double blinded, placebo controlled clinical trial, 112 patients aged 5-12 years ASA (American Society of Anesthesiologists) class I were enrolled to receive 0.5 mg/kg iv dexamethasone up to 8 mg (n=56), as study group and placebo group had received equivalent volume of 0.9% normal saline at the time of induction of general anesthesia (n=56), as control group. The anesthetic regimen was standardized for all patients. The incidence of early and late vomiting, the time to first oral intake and duration of intra venous fluid administration was recorded.Results: Data analysis showed that the overall incidence of early and late vomiting was significantly lesser in dexamethasone group than the control one. The time to first oral intake and duration of intravenous fluid therapy were also significantly shorter in dexamethasone group.Conclusion: A single dose of dexamethasone at induction of anesthesia significantly decreased the incidence of postoperative vomiting in early and late recovery phase and shortened the time to first oral intake and duration of intravenous fluid therapy.Key words: Dexamethasone, Postoperative Nausea and Vomiting, Tonsillectomy, Postoperative Oral Intake