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The effect of dexamethasone on postoperative vomiting and oral intake after adenotonsillectomy

M R Fazel1, A Yegane-Moghaddam, Z Forghani

  • 1Department of Anesthesiology, School of Medicine, Kashan University of Medical Science, Kashan, Iran. drmfazel@yahoo.com

International Journal of Pediatric Otorhinolaryngology
|June 5, 2007
PubMed

Insights

Preoperative intravenous dexamethasone significantly reduced postoperative vomiting and shortened recovery times in children undergoing adenotonsillectomy. This effective antiemetic strategy improved patient outcomes by decreasing nausea and enabling earlier oral intake.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pharmacology

Background:

  • Postoperative nausea and vomiting (PONV) are common complications following adenotonsillectomy in children.
  • Effective management of PONV is crucial for patient comfort and recovery.
  • Dexamethasone is a corticosteroid with known antiemetic properties.

Purpose of the Study:

  • To evaluate the efficacy of a single preoperative intravenous dose of dexamethasone in preventing and reducing postoperative emesis in pediatric patients undergoing adenotonsillectomy.
  • To compare the incidence of early and late vomiting between patients receiving dexamethasone and those receiving a placebo.

Main Methods:

  • A double-blind, placebo-controlled clinical trial was conducted with 100 pediatric patients (aged 5-15 years, ASA classes I-II).
  • Participants were randomized to receive either 0.5 mg/kg intravenous dexamethasone or an equivalent volume of saline preoperatively.
  • Standardized anesthetic and surgical protocols were applied. Outcomes measured included the incidence of early and late vomiting, time to first oral intake, and duration of intravenous fluid therapy.

Main Results:

  • The dexamethasone group exhibited a significantly lower overall incidence of both early and late postoperative vomiting compared to the placebo group.
  • Patients who received dexamethasone experienced a significantly shorter time to their first oral intake.
  • The duration of intravenous hydration was also significantly reduced in the dexamethasone group.

Conclusions:

  • A single preoperative intravenous dose of dexamethasone is effective in significantly decreasing the incidence of postoperative vomiting in pediatric adenotonsillectomy patients.
  • Dexamethasone administration also leads to a shorter time to first oral intake and a reduced duration of intravenous therapy, facilitating faster recovery.
  • This study supports the use of preoperative intravenous dexamethasone as a valuable strategy for managing PONV in this patient population.
Abstract

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