THE EFFECT OF DEXAMETHASONE ON POST - OPERATIVE NAUSEA AND VOMITING IN PATIENTS WHO UNDERWENT TONSILLITIS SURGERY AT THE ADESH INSTITUTE OF MEDICAL SCIENCE AND RESEARCH UNIVERSITY

: PONV occurs frequently after day case tonsillectomy surgery both 5-HT3 antagonists and dexamethasone are superior to placebo in the prophylaxis of PONV in his setting. Our study has compared the efficacy of ondansetron plus dexamethasone with each anti-emetic alone for the prevention of PONV in patients undergoing day case tonsillectomy surgery. Present study was undertaken on 279 patients in the age group of 10-38yrs. Group 1 received Inj. Dexamethasone 8mg as single dose I V bolus 5 minutes before induction of anaesthesia. Group 2 received Inj. Ondansetron 4mg as single dose I V bolus 5 minutes before induction of anaesthesia. Group 3 received Inj. Ondansetron 4mg with Inj. Dexamethasone 8mg as single dose I V bolus 5 minutes before induction of anaesthesia A standard anaesthetic protocol was used in all the patients. As per our observations, the incidence of PONV in 0 – 4 hours postoperative period was statistically significant. The observations were inconclusive beyond the 4 hour period in combination group as well as either drug group. Combination of Inj. Ondansetron 4mg with Inj. This table depicts the nausea and vomiting in next 4 to 12 hours and the result shows that in group 3 the incidence of nausea and vomiting is decreased as compared to the other two groups. We found it very good the patients on group 3 have no chief complaint and they don’t feel uncomfortable. The chi-square comes to be 14.2909 and p-value is 0.006422. The result is significant at p<0.05. and colleagues20 and Kim and colleagues compared DEX doses ranging from 0.0625 to 1.0 mgkg (12) in pediatric tonsillectomy. They did not observe a dose dependent effect on the incidence of PONV and pain. Karaman and colleagues (13) compared the effects of two doses of DEX, 0.2 and 0.7 mgkg, (12) with a placebo group on PONV after tonsillectomy, and observed a reduction in the incidence of PONV in the groups receiving DEX with no difference between the two doses. Our results are in line with these reports. In most studies, administration of DEX is not associated with significant side-effects in children undergoing tonsillectomy. (13) Also we didn’t encountered by any side effect of this drug. Moreover, a recent study in 2788 children did not observe a dose-dependent elevation of postoperative haemorrhage with perioperative DEX administration (0.5 or 1.0 mgkg (6) ) however our study is small and does not have that much sample size so our view over post-operative bleeding after DEX injections is not confirmative. In our study we observed the total incidence of nausea is decreased after combination of DEX and Ondasetron injections.